61. Aikenhead 2011: Effectiveness and cost-effectiveness of paediatric bariatric surgery: a systematic review

LLM response

21 quote(s) from publication full text (mean similarity 91.5%)

Here is the assessment of the systematic review using AMSTAR and PRISMA:

A1. Was an 'a priori' design provided?
"We performed a systematic review to examine the effectiveness of surgical interventions to treat obese children and adolescents, and whether they are cost-effective."
The authors state they performed a systematic review, implying an a priori design.
[Yes]

A2. Was there duplicate study selection and data extraction?
No mention of duplicate study selection and data extraction in the text.
[No]

A3. Was a comprehensive literature search performed?
"Multi-database searching was used to ensure comprehensive article retrieval. Searches were conducted in PubMed, Embase, ISI Web of Science and the Cochrane Library to 6 September 2010."
Multiple databases were searched up to a recent date.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
"Thirty-seven relevant papers on bariatric surgery effectiveness in 831 children or adolescents were included, spanning 36 years."
The number of included studies is provided, but no list of excluded studies is given.
[No]

A6. Were the characteristics of the included studies provided?
"This review serves to update the medical profession to rely on the best available evidence, including the methodological shortcomings of the majority of prevention trials (9)."
Some study characteristics are mentioned, but no details are provided in aggregate form like a table.
[No]

A7. Was the scientific quality of the included studies assessed and documented?
"Existing evidence - although based generally on underpowered, retrospective studies - suggests that bariatric surgery in older children results in significant weight loss and improvements in comorbidities and quality of life."
The quality of included studies is commented on in general terms, but no formal quality assessment seems to have been done.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
"However, postoperative complications, compliance and follow-up may be more problematic in adolescents than adults, and availability of long-term data on safety, effectiveness and cost-effectiveness remains largely unknown."
The limitations of the evidence base are factored into the conclusions.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
"Formal meta-analysis was not attempted due to the marked heterogeneity of study designs and outcome measures among the included studies."
A meta-analysis was appropriately not conducted due to heterogeneity between studies.
[NA]

A10. Was the likelihood of publication bias assessed?
No mention of assessing publication bias.
[NA]

A11. Was the conflict of interest included?
"No conflict of interest was declared."
A conflict of interest statement is provided for the systematic review, but not for the individual included studies.
[No]

P1. Title
"Effectiveness and cost-effectiveness of paediatric bariatric surgery: a systematic review"
The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
The abstract contains labeled sections covering the background, methods, results and conclusions.
[Yes]  

P3. Introduction / Rationale
"During the last two decades the prevalence of childhood and adolescent obesity has grown rapidly in most regions of the world. Despite reports of levelling off in some countries (1–3), childhood obesity and its associated morbidities and costs are considerable and increasing in scale in many countries (4,5), particularly among socioeconomically disadvantaged segments of many populations (4)."
The rationale for the review is described in the context of the increasing prevalence and burden of childhood obesity.
[Yes]

P4. Introduction / Objectives
"The treatment options for children and adolescents include changes in dietary and exercise behaviour as well as pharmacotherapy and bariatric surgery (10)."
The objective of examining surgical treatment options for pediatric obesity is stated.
[Yes]

P5. Methods / Protocol and registration
No mention of a pre-registered protocol.
[No]

P6. Methods / Eligibility criteria
"Articles with an abstract in English and full text in Danish, English, French, or Norwegian language were eligible. In addition, subjects had to be ≤19 years of age. At least one postoperative weight loss measure had to be reported, with a minimum follow-up time of 1 year post surgery."
Eligibility criteria for study designs, participants, interventions and outcomes are provided.
[Yes]

P7. Methods / Information sources
"Multi-database searching was used to ensure comprehensive article retrieval. Searches were conducted in PubMed, Embase, ISI Web of Science and the Cochrane Library to 6 September 2010."
The databases searched and last search date are reported.
[Yes]

P8. Methods / Search
The full search strategies are not provided.
[No]

P9. Methods / Study selection
"The search strategy yielded 3724 citations of which 273 articles were identified as potentially relevant. Full copies of 247 of these papers were obtained; full copies of the remaining 26 (9.5%) publications of unknown eligibility were unobtainable despite numerous attempts."
The number of studies at each stage of the selection process is reported.
[Yes]

P10. Methods / Data collection process
No details are provided on the data extraction process.
[No]

P11. Methods / Data items
No list of data items that were sought is provided.
[No]

P12. Methods / Risk of bias in individual studies
"Existing evidence - although based generally on underpowered, retrospective studies - suggests that bariatric surgery in older children results in significant weight loss and improvements in comorbidities and quality of life."
Risk of bias is commented on in general terms, but no formal risk of bias assessment of individual studies seems to have been done.
[No]

P13. Methods / Summary measures
No summary measures are specified.
[No]

P14. Methods / Synthesis of results
"Formal meta-analysis was not attempted due to the marked heterogeneity of study designs and outcome measures among the included studies."
[NA]

P15. Methods / Risk of bias across studies
No assessment of risk of bias across studies is mentioned.
[NA]

P16. Methods / Additional analyses
No additional analyses are mentioned.
[NA]

P17. Results / Study selection
"The search strategy yielded 3724 citations of which 273 articles were identified as potentially relevant. Full copies of 247 of these papers were obtained; full copies of the remaining 26 (9.5%) publications of unknown eligibility were unobtainable despite numerous attempts."
A flow diagram of the study selection process is provided in Appendix 2.
[Yes]

P18. Results / Study characteristics
"Thirty-seven relevant papers on bariatric surgery effectiveness in 831 children or adolescents were included, spanning 36 years. This review serves to update the medical profession to rely on the best available evidence, including the methodological shortcomings of the majority of prevention trials (9)."
Some limited details on the included studies are provided, but no table of study characteristics is included.
[No]

P19. Results / Risk of bias within studies
"Existing evidence - although based generally on underpowered, retrospective studies - suggests that bariatric surgery in older children results in significant weight loss and improvements in comorbidities and quality of life."
Risk of bias is commented on in general terms, but results are not provided for each study.
[No]

P20. Results / Results of individual studies
Results of individual studies are not systematically presented.
[No]

P21. Results / Synthesis of results
No meta-analysis was performed.
[NA]

P22. Results / Risk of bias across studies
No assessment of risk of bias across studies is reported.
[NA]

P23. Results / Additional analysis
No additional analyses were reported.
[NA]

P24. Discussion / Summary of evidence
"Strong evidence for successful and cost-effective strategies is still generally lacking, in large part due to the methodological shortcomings of the majority of prevention trials (9)."
The main findings are summarized, noting the limitations of the evidence base.
[Yes]

P25. Discussion / Limitations
"However, most children do not require treatment as aggressive as bariatric surgery, and the long-term risks of surgery for this age group are not yet known."
Limitations of the evidence are discussed.
[Yes]

P26. Discussion / Conclusions
"Bariatric surgery is promoted as a treatment option for children and adolescents for several reasons as outlined above, but these also generate some controversy."
The results are interpreted and implications for future research are noted.
[Yes]

P27. Funding
"The project that led to this paper was funded by the WHO Health Evidence Network of the World Health Organization."
Sources of funding for the systematic review are reported.
[Yes]

62. Al-Hozaim 2010: Laparoscopic-assisted anorectal pull-through for anorectal malformations: a systematic review and the need for standardization of outcome reporting

LLM response

22 quote(s) from publication full text (mean similarity 98.5%)

Here is the assessment of the systematic review using AMSTAR and PRISMA:

A1
Quote: "A systematic review was conducted. The search was limited to studies reported in English and performed in addition to Medline and PubMed, a manual search of the Journal of Pediatric Surgery, Pediatric Surgery International, Surgical Endoscopy, and the Journal of Laparoendoscopic & Advanced Surgical Techniques published between June 2000 and April 2008 was conducted."
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
Quotes: "A data extraction form was created to standardize the collection of study elements from each included article. This form included the following information: inclusion/exclusion criteria, study title, author, characteristics of the journal (year of publication), study design, study period, sample size, and the focus of the study in use of the LAARP as a primary procedure or after colostomy."
Reasoning: A standardized data extraction form was used, but no mention of duplicate study selection and extraction.
[No]

A3
Quotes: "A systematic search of the MEDLINE, PUBMED, and Cochrane databases (June 2000 to April 2008) was conducted. The search terms used were "laparoscopic," "pull-through," "anorectal malformation," and "imperforate anus." In addition, a manual search of 4 surgical journals from the same period was performed. The journals searched were "The Journal of Pediatric Surgery," "Pediatric Surgery International," "Surgical Endoscopy," and "Journal of Laparoendoscopic & Advanced Surgical Techniques.""
Reasoning: At least two databases were searched and supplemented by manual search of journals.
[Yes]

A4
Quotes: "Inclusion criteria were studies of ARMs, regardless of level of the defect, with or without associated anomalies, use of LAARP as a primary procedure or with colostomy, and studies reported after the year 2000. Exclusion criteria included studies that were not reported in English and those that did not deal with human subjects."
Reasoning: Inclusion criteria were specified regardless of publication status. Exclusion criteria included language and non-human studies.
[Yes]

A5
Quotes: "Seventeen studies were included in the final analysis. Of the included studies, none were randomized, 2 were prospective in nature, and 4 compared outcomes of posterior sagittal anorectoplasty and LAARP. The studies included 124 patients (96 males, 28 females) with 80% reported as having high/intermediate malformations."
Reasoning: The number of included studies was provided, but no list of excluded studies.
[No]

A6
Quote: "The studies included 124 patients—96 males (77.4%) and 28 females (22.6%). Of the 124 patients, 110 (88.7%) had undergone previous colostomy, whereas 14 patients (11.2%) had undergone a primary laparoscopic repair without a colostomy. Most patients (80%) had either a high or intermediate ARM."
Reasoning: Aggregated characteristics of the included studies were provided.
[Yes]

A7
Quotes: "Analysis of study designs revealed 2 prospective studies (11.7%) [2,3], 4 comparative studies (23.5%) [2,4–6], and no randomized studies."
"Recently, Ozzechi et al [22] recently documented the scarcity of high-level evidence pertaining to minimal access surgery in children. In this article, we closely examined indications of LAARP because it was initially described. To the best of our knowledge, this is the first systematic review to examine literature pertaining to LAARP."
Reasoning: Study designs were reported but no formal assessment of scientific quality was described. The authors acknowledge the lack of high-quality evidence.
[No]

A8
Quote: "To the best of our knowledge, this is the first systematic review to examine literature pertaining to LAARP."
Reasoning: Scientific quality was not used in formulating conclusions, as it was not assessed.
[No]

A9
Reasoning: This was a systematic review without a meta-analysis, so methods for combining studies are not applicable.
[NA]

A10
Reasoning: Publication bias was not assessed in this systematic review without a meta-analysis.
[NA]

A11
Reasoning: Sources of funding and conflicts of interest for the systematic review and included studies were not reported.
[No]

P1
Quote: "Laparoscopic-assisted anorectal pull-through for anorectal malformations: a systematic review and the need for standardization of outcome reporting"
Reasoning: The title identifies the article as a systematic review.
[Yes]  

P2
Quote: "Introduction: Laparoscopic-assisted anorectal pull-through (LAARP) is becoming an increasingly common procedure to correct high and intermediate anorectal malformations (ARMs). The aim of this review was to evaluate worldwide experiences with LAARP with regard to indications, outcomes, and quality of reporting.
Method: A systematic review was conducted. The search was limited to studies reported in English and performed in addition to Medline and PubMed, a manual search of the Journal of Pediatric Surgery, Pediatric Surgery International, Surgical Endoscopy, and the Journal of Laparoendoscopic & Advanced Surgical Techniques published between June 2000 and April 2008 was conducted.
Results: Seventeen studies were included in the final analysis. Of the included studies, none were randomized, 2 were prospective in nature, and 4 compared outcomes of posterior sagittal anorectoplasty and LAARP. The studies included 124 patients (96 males, 28 females) with 80% reported as having high/intermediate malformations. All studies reported short-term outcomes. Reported outcomes included continence, rectal prolapse, the position of the rectum (7 studies using Kelly score), manometry (1 study), contrast enema (1 study), postural endosonography (3 studies), and postoperative complications (3 studies). Outcomes varied widely between reports precluding a meta-analysis.
Conclusion: The number of studies dealing with LAARP is low. There is a need for both a standardization and improvement in the quality of reporting in LAARP research. This will ultimately allow for evidence-based surgical decision making."
Reasoning: A structured abstract is provided with labeled sections for background, methods, results and conclusion.
[Yes]

P3
Quote: "Over the past several years, techniques have evolved in the repair of high and intermediate anorectal malformations (ARMs), starting with the abdominoperineal pull-through, sacroperineal pull-through, and posterior sagittal anorectoplasty (PSARP) and now moving toward the recently reported laparoscopically assisted anorectal pull-through (LAARP) procedure."
Reasoning: The rationale for the review is described in the context of the evolution of surgical techniques for ARMs.
[Yes]

P4
Reasoning: No explicit statement of the review questions with reference to PICOS.
[No]

P5
Reasoning: No mention of a review protocol or registration.
[No]

P6
Quotes: "Inclusion criteria were studies of ARMs, regardless of level of the defect, with or without associated anomalies, use of LAARP as a primary procedure or with colostomy, and studies reported after the year 2000. Exclusion criteria included studies that were not reported in English and those that did not deal with human subjects."
Reasoning: Study characteristics used as eligibility criteria were specified.
[Yes]

P7
Quotes: "A systematic search of the MEDLINE, PUBMED, and Cochrane databases (June 2000 to April 2008) was conducted."
"In addition, a manual search of 4 surgical journals from the same period was performed. The journals searched were "The Journal of Pediatric Surgery," "Pediatric Surgery International," "Surgical Endoscopy," and "Journal of Laparoendoscopic & Advanced Surgical Techniques.""
Reasoning: Electronic databases and dates of coverage were reported, along with manual search of specific journals.
[Yes]

P8
Reasoning: The full search strategy was not presented such that it could be repeated.
[No]

P9
Quote: "Inclusion criteria were studies of ARMs, regardless of level of the defect, with or without associated anomalies, use of LAARP as a primary procedure or with colostomy, and studies reported after the year 2000. Exclusion criteria included studies that were not reported in English and those that did not deal with human subjects."
Reasoning: The process of study selection based on inclusion and exclusion criteria was described.
[Yes]

P10
Quote: "A data extraction form was created to standardize the collection of study elements from each included article. This form included the following information: inclusion/exclusion criteria, study title, author, characteristics of the journal (year of publication), study design, study period, sample size, and the focus of the study in use of the LAARP as a primary procedure or after colostomy."
Reasoning: A standardized data collection form was used to extract data from reports.
[Yes]

P11
Reasoning: Variables for which data were sought were not pre-defined.
[No]  

P12
Reasoning: Methods for assessing risk of bias in individual studies were not described.
[No]

P13
Reasoning: No summary measures were specified, as no meta-analysis was performed.
[NA]

P14
Reasoning: No meta-analysis was performed, so methods for data synthesis are not applicable.
[NA]

P15
Reasoning: Risk of bias across studies was not assessed in this systematic review without a meta-analysis.
[NA]

P16
Reasoning: No additional analyses were reported.
[NA]

P17
Quote: "Seventeen studies were included in the final analysis."
Reasoning: The number of included studies was reported, but no details on the number screened or assessed for eligibility, reasons for exclusions, or a flow diagram.
[No]

P18
Quote: "The studies included 124 patients—96 males (77.4%) and 28 females (22.6%). Of the 124 patients, 110 (88.7%) had undergone previous colostomy, whereas 14 patients (11.2%) had undergone a primary laparoscopic repair without a colostomy. Most patients (80%) had either a high or intermediate ARM."
Reasoning: Aggregated characteristics of the included studies were provided.
[Yes]

P19
Reasoning: Risk of bias of individual studies was not assessed.
[No]

P20
Reasoning: Results for individual studies were not presented.
[No]

P21
Reasoning: No meta-analysis was performed.
[NA]

P22
Reasoning: Risk of bias across studies was not assessed in this systematic review without a meta-analysis.
[NA]

P23
Reasoning: No additional analyses were reported.
[NA]

P24
Quote: "One in 5000 infants is born with an ARM. The evolution of surgical techniques for dealing with this complex group of malformations led to the description of the PSARP by deVries and Pena [18] in 1982. Posterior sagittal anorectoplasty became the standard of care for dealing with ARM. Despite the excellent exposure of anatomy and exact placement of the distal rectum within the muscle complex, the technique is not perfect, especially in patients with "high" ARM defects [19–21]."
Reasoning: The main findings are summarized, including the evolution of surgical techniques and limitations of the PSARP approach.
[Yes]

P25
Quote: "Recently, Ozzechi et al [22] recently documented the scarcity of high-level evidence pertaining to minimal access surgery in children. In this article, we closely examined indications of LAARP because it was initially described. To the best of our knowledge, this is the first systematic review to examine literature pertaining to LAARP."
Reasoning: Limitations in the evidence base are acknowledged.
[Yes]

P26
Quote: "In conjunction with the increased interest in minimal access surgery in children, there has been increased awareness among surgeons of the importance of evidence-based surgery."
Reasoning: Implications for future research in terms of the need for evidence-based surgery are provided.
[Yes]

P27
Reasoning: Sources of funding for the systematic review were not described.
[No]

63. Allen 2015: Pediatric emergency department thoracotomy: A large case series and systematic review

LLM response

12 quote(s) from publication full text (mean similarity 99%)

2 quote(s) from the LLM prompt briefing (mean similarity 73%) - were instructions quoted (ok) or examples (unwanted beahviour)?

Here is the assessment of the systematic review's methodological quality based on AMSTAR:

A1. "We reviewed our experience and performed a systematic review of reports of EDT in pediatric patients." The review mentions performing a systematic review, but does not specify an a priori protocol. [No]

A2. No mention of duplicate study selection and data extraction. [No]

A3. "We searched PubMed, MEDLINE, and Embase by using the key words "pediatrics", and "children". Bibliographies of relevant publications were reviewed to identify reports that were not initially located with the Medline search." At least 2 databases and checking reference lists were used. [Yes] 

A4. No mention of including grey literature. [No]

A5. No list of included and excluded studies provided. [No]

A6. Table 1 provides some characteristics of the included studies like sample size, outcomes, and survival rates. However, key details like population characteristics are missing. [No]

A7. "For publications that did not report certain variables, those cases were systematically excluded when analyzing that missing variable." This suggests assessing study quality based on missing data, but the specific criteria are not described a priori. [No]

A8. No mention of study quality being considered in the analysis and conclusions. [No]

A9. Quantitative synthesis of studies was not performed. [NA]

A10. No assessment of publication bias. [NA] 

A11. No reporting of conflicts of interest for the included studies. The funding source for the systematic review itself is reported. [No]

Here is the assessment of the systematic review's reporting quality based on PRISMA:

P1. "Pediatric emergency department thoracotomy: A large case series and systematic review" The title identifies the article as a systematic review. [Yes]

P2. The abstract is structured with labeled sections for Background/purpose, Methods, Results, and Conclusion. However, some details like data sources and study appraisal methods are missing. [No]

P3. "Trauma remains the leading cause of morbidity and mortality in children and adolescents [1,2]. By recognizing this, care of the injured child has improved with aggressive efforts to standardize treatment." Provides rationale for the review in the context of trauma morbidity and mortality in children. [Yes]

P4. "To address this issue, we reviewed our experience at a level 1 trauma center and report the largest analysis over the past 25 years. In conjunction, we performed a systematic review of all published reports regarding pediatric EDT and combined the data from those reports with the data from our institution" Specifies the review questions being addressed. [Yes]

P5. No mention of a review protocol or registration. [No]

P6. "These reports obtained from a Medline search for all publications regarding EDT in the pediatric population for the past 40 year using the keywords "thoracotomy", "emergency", "trauma", "resuscitation", "pediatrics", and "children"." Specifies study eligibility criteria and rationale. [Yes]

P7. "We searched PubMed, MEDLINE, and Embase by using the key words "pediatrics", and "children". Bibliographies of relevant publications were reviewed to identify reports that were not initially located with the Medline search." Describes information sources and dates searched. [Yes]

P8. The full search strategy is not provided such that it could be repeated. [No]

P9. "These reports obtained from a Medline search for all publications regarding EDT in the pediatric population for the past 40 year using the keywords "thoracotomy", "emergency", "trauma", "resuscitation", "pediatrics", and "children". Bibliographies of relevant publications were reviewed to identify reports that were not initially located with the Medline search." Describes the study selection process. [Yes]

P10. No description of the data collection process. [No]

P11. Table 1 lists the variables for which data were extracted. [Yes]  

P12. No description of assessing risk of bias in individual studies. [No]

P13. No summary measures specified. [No]

P14. No description of methods for combining results. [NA]

P15. No assessment of risk of bias across studies. [NA]

P16. No additional analyses performed. [NA]

P17. Figure 2 provides a flow diagram of the number of studies screened, assessed for eligibility, and included. [Yes]

P18. Table 1 provides the characteristics of included studies. [Yes]

P19. No presentation of risk of bias within studies. [No]

P20. Figure 1 and Table 3 present the outcomes for each study. [Yes]

P21. No meta-analysis performed. [NA]

P22. No assessment of risk of bias across studies reported. [NA]

P23. No additional analyses performed. [NA] 

P24. "Overall, the mortality rates are comparable between adults and pediatric patients following EDT. Children who sustain penetrating trauma and have SOL in the emergency department or are without SOL for a short period of time prior to arrival have been salvageable. There are no reported survivors in children less than the age of 14 years who required an EDT after sustaining penetrating trauma." Summarizes the main findings. [Yes]

P25. "There are limitations to this study. First, all of the data obtained from our institution were collected retrospectively, and thus not specifically collected for research purposes. As for all data reviewed, some of the variables may have been missing or misclassified. Also, differences in trauma management between physicians and institutions may not allow for generalizations to be made." Discusses limitations. [Yes]

P26. "Continued evaluation of this technique is warranted to develop adequate guidelines." Provides a general interpretation and implications for future research. [Yes]

P27. "* Corresponding author at: Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL 33136. Tel.: +1 305 243 5072." Reports the funding source for the systematic review. [Yes]

64. Allin 2015: Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management

LLM response

28 quote(s) from publication full text (mean similarity 100%)

A1
Quotes: "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)."
Reasoning: The authors state that the review was conducted according to a pre-specified protocol that was registered, indicating an a priori design.
[Yes]

A2
Quotes: "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK). Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion."
Reasoning: Study selection and data extraction were done independently by two investigators with a process for resolving conflicts, meeting the criteria.
[Yes]

A3
Quotes: "All study designs except expert opinion were included, and no restrictions were made on the basis of study language or geographical location. Studies were included if they comprised the following participants and interventions, and at least one of the outcomes of interest."
"previously published literature and expert opinion. Multiple search strategies were used to identify relevant articles from Medline, Embase, Cinahl, the Cochrane library, and Google scholar, published between 1st January 2000 and 31st December 2012. Search terms were identified from database thesauri (italics) and free text, relating to Gastroschisis (e.g. Gastroschisis, Digestive system abnormalities, abdominal wall defects), method of closure (e.g. silo, primary adj3 closure, traditional adj3 closure) and relevant outcome measures (e.g. hospital+ ischaemic bowel, complications), and were combined using Boolean operators."
Reasoning: The authors searched multiple electronic databases, provided search terms, and supplemented the search with other sources like Google Scholar.
[Yes]

A4
Quotes: "All study designs except expert opinion were included, and no restrictions were made on the basis of study language or geographical location."
Reasoning: The authors explicitly state that no restrictions were made based on publication status or language.
[Yes]

A5
Quotes: "Using the stated search strategy, 3081 papers were identified. After removal of duplicates, 751 unique articles remained. From this, 8 papers were deemed to meet the inclusion criteria, all of which were cohort studies (Fig. 1). No randomised controlled trials were identified that met the inclusion criteria. All papers bar one were published in English language journals. One Spanish paper was translated. Unpublished data were obtained from two authors [2, 9]."
Reasoning: The authors provide a flow diagram showing the number of included and excluded studies at each stage. The excluded studies are not explicitly listed but the reasons for exclusion at each stage are provided.
[Yes]

A6
Quotes: "The included studies comprised a total of 804 infants with simple gastroschisis, 488 of whom underwent OPFC and 316 of whom underwent SR. The largest study was Owen 2010 [2] with 290 eligible patients. The majority of the remaining studies included fewer than 50 participants (Table 2)."
"Although reporting of baseline characteristics was variably done by the included studies, where it was reported, there were no statistically significant differences in birth-weight, gestational age, or associated anomalies between the OPFC and SR groups."
Reasoning: The authors provide aggregate data on the number of participants and interventions in each included study in Table 2. They also comment on the reporting of baseline characteristics.
[Yes]

A7
Quotes: "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK). Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion. Where required, unpublished data were requested from the authors of each of the included studies to allow for meta-analysis."
"Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
Reasoning: The authors used the STROBE checklist and GRADE criteria to assess the quality and risk of bias of the included studies.
[Yes]

A8
Quotes: "Despite showing some benefit of OPFC over SR, our results are tempered by the low quality of the available studies, which were small and variably reported. Coordinating research through a National Paediatric Surgical Trials Unit could alleviate many of these problems. A similar national approach could be used in other smaller surgical specialties."
Reasoning: The authors appropriately consider the low quality of the included studies when formulating their conclusions and recommendations.
[Yes]

A9
Quotes: "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout. Dichotomous outcomes were meta-analysed using Mantel–Haenszel fixed effects methods to produce summary odds ratios with 95% confidence intervals. Continuous variables were meta-analysed using the inverse-variance fixed-effect method to produce weighted mean differences and 95% confidence intervals. All analyses were performed using Review Manager 5.2 (Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012.)"
Reasoning: The authors assessed heterogeneity and used appropriate fixed-effect methods to combine the study results in meta-analysis.
[Yes]

A10
Quotes: None relevant.
Reasoning: The authors did not assess publication bias, likely because there were fewer than 10 included studies, making assessment not feasible.
[NA] 

A11
Quotes: "Marian Knight is funded by a National Institute for Health Research Professorship. This article presents independent research partly funded by the National Institute for Health Research (http:// www.nihr.ac.uk/Pages/default.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."
Reasoning: The authors declare the source of funding for the systematic review. However, they do not report sources of support for each of the included primary studies.
[No]

P1
Quotes: "Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2
Quotes: The abstract contains labeled sections for Background, Methods, Results, and Conclusions.
Reasoning: The abstract is structured with the required sections.
[Yes]

P3
Quotes: "With variation existing around the specifics of management of some of the most common neonatal surgical conditions including oesophageal atresia, gastroschisis and Hirschsprung's disease, research should be commonplace. Yet despite these fertile conditions for research, for these three conditions, only fourteen prospectively registered clinical trials and two systematic reviews could be identified on a search of the major registries at the time of writing (Table 1). Whilst both the low incidence of many of the studied conditions, and the difficulties in gaining ethical approval are at least in part responsible for the lack of paediatric surgical research, we do not believe that they account for the whole story."
Reasoning: The authors describe the rationale for the review in the context of the lack of research on common neonatal surgical conditions despite variation in management practices.
[Yes]

P4
Quotes: "Using a systematic review and meta-analysis of gastroschisis as an example, we aimed to highlight some of the key challenges in paediatric surgical research, and suggest ways in which the strength of our clinical evidence base could be improved."
Reasoning: The objective is stated, although it does not explicitly reference the PICOS elements.
[Yes]

P5
Quotes: "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)."
Reasoning: The authors state that a protocol exists and provide the registration number and database where it can be accessed.
[Yes]

P6
Quotes: "Studies were included if they involved infants born with simple gastroschisis, defined as gastroschisis with an intact continuous bowel that is not compromised or breached at delivery or presentation. Infants with complex gastroschisis, defined as the presence of at least one of intestinal perforation, necrosis, or atresia were excluded from this review, as they only account for approximately 11.5% of infants with gastroschisis, are known to have a worse prognosis than the majority with simple gastroschisis [2], and thus represent a major confounder in any examination of the outcomes of different management techniques."
Reasoning: The authors specify the study characteristics (participants, interventions) used as eligibility criteria along with a rationale.
[Yes]

P7
Quotes: "previously published literature and expert opinion. Multiple search strategies were used to identify relevant articles from Medline, Embase, Cinahl, the Cochrane library, and Google scholar, published between 1st January 2000 and 31st December 2012."
Reasoning: The authors describe the information sources searched, including the databases and date ranges.
[Yes]

P8
Quotes: None relevant.
Reasoning: The authors do not present the full electronic search strategy for any of the databases.
[No]

P9
Quotes: "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK). Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion."
Reasoning: The authors state the process for selecting studies, including the number of reviewers and how disagreements were resolved.
[Yes]

P10
Quotes: "Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion. Where required, unpublished data were requested from the authors of each of the included studies to allow for meta-analysis."
Reasoning: The authors describe the method of data extraction, including the number of reviewers, how disagreements were resolved, and the process for obtaining missing data.
[Yes]

P11
Quotes: "Primary outcome measures:
1. Mortality
2. Length of hospital stay
3. Time to complete enteral feeding/duration of parenteral feeding
Secondary outcome measures:
1. Duration of ventilator use
2. Infective complication
3. Perforation
4. Ischaemic bowel
5. Necrotising Enterocolitis (NEC)
6. Anastomotic stricture
7. Adhesional small bowel obstruction
8. Complications related to stoma
9. Short bowel syndrome
10. Liver disease associated with intestinal failure"
Reasoning: The authors list all the primary and secondary outcomes for which data were sought.
[Yes]

P12
Quotes: "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
Reasoning: The authors describe the methods used to assess risk of bias in the included studies.
[Yes]

P13
Quotes: None relevant.
Reasoning: The authors do not explicitly state the principal summary measures. However, based on the forest plots, it appears they used odds ratios for dichotomous outcomes and mean differences for continuous outcomes.
[No]

P14
Quotes: "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout. Dichotomous outcomes were meta-analysed using Mantel–Haenszel fixed effects methods to produce summary odds ratios with 95% confidence intervals. Continuous variables were meta-analysed using the inverse-variance fixed-effect method to produce weighted mean differences and 95% confidence intervals."
Reasoning: The authors describe the methods used to combine the study results, including the assessment of heterogeneity and the use of fixed-effect meta-analysis methods.
[Yes]

P15
Quotes: None relevant.
Reasoning: The authors do not mention any assessment of risk of bias across studies, such as publication bias or selective reporting.
[No]

P16
Quotes: None relevant.
Reasoning: The authors do not describe any additional analyses.
[No]

P17
Quotes: "Using the stated search strategy, 3081 papers were identified. After removal of duplicates, 751 unique articles remained. From this, 8 papers were deemed to meet the inclusion criteria, all of which were cohort studies (Fig. 1). No randomised controlled trials were identified that met the inclusion criteria. All papers bar one were published in English language journals. One Spanish paper was translated. Unpublished data were obtained from two authors [2, 9]."
Reasoning: The authors provide a flow diagram (Figure 1) showing the number of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
[Yes]

P18
Quotes: The authors present the characteristics of each included study, including the setting, number of neonates, intervention, and outcomes in Table 2.
Reasoning: The characteristics of each included study are presented with citations.
[Yes]

P19
Quotes: None relevant.
Reasoning: The authors assess the quality and risk of bias of the included studies using STROBE and GRADE, but do not present the results for each individual study.
[No]

P20
Quotes: The authors present forest plots (Figures 2 and 3) showing the results of individual studies for each primary outcome, with odds ratios and 95% confidence intervals.
Reasoning: The results for each individual study are presented for all outcomes, with effect estimates and confidence intervals.
[Yes]

P21
Quotes: The authors present forest plots (Figures 2 and 3) showing the pooled results of the meta-analyses for each primary outcome, with odds ratios and 95% confidence intervals.
Reasoning: The results of each meta-analysis are presented with confidence intervals and measures of consistency (heterogeneity).
[Yes]

P22
Quotes: None relevant.
Reasoning: The authors do not present any assessment of risk of bias across studies.
[No]

P23
Quotes: None relevant.
Reasoning: The authors do not report any additional analyses.
[No]

P24
Quotes: "All three primary outcome measures appeared to favour the OPFC group over the SR group. Both length of stay and number of post-operative days to complete enteral feeding were clinically and statistically significantly longer in the SR group, with a mean difference of 8.97 days, (95% CI 2.14–15.80 days), and a mean difference of 7.19 days (95%CI 2.01–12.36 days) respectively (Fig. 2). Although the odds of death were raised in the SR group (OR 1.96, 95%CI 0.71–5.35), this difference was not statistically significant (Table 3 and Fig. 2). Results for secondary outcome measures are displayed in Table 3 and Fig. 3."
Reasoning: The authors summarize the main findings for the primary and secondary outcomes, including the strength of evidence based on the effect estimates and confidence intervals.
[Yes]

P25
Quotes: "As is representative of most research in paediatric surgery [14], our meta-analysis was limited by the fact that the majority of studies available for inclusion were small, retrospective case series or cohort studies. Due to the impact of chance and confounding on the results of these studies, it is impossible to generate robust guidelines based upon them. To produce evidence-based guidelines, the type of study used for assessment of any given intervention should progress as described by the IDEAL recommendations [15] through the use of large cohort studies, to the gold standard randomised controlled trial. Doing so not only increases the weight of the conclusions of the primary research, but also of any meta-analysis including them."
Reasoning: The authors discuss several limitations of the review, including the small size and retrospective nature of the included studies, the potential for chance and confounding to impact the results, and the inability to generate robust guidelines based on these studies alone.
[Yes]

P26
Quotes: "Despite showing some benefit of OPFC over SR, our results are tempered by the low quality of the available studies, which were small and variably reported. Coordinating research through a National Paediatric Surgical Trials Unit could alleviate many of these problems. A similar national approach could be used in other smaller surgical specialties."
Reasoning: The authors provide a general interpretation of the results in the context of the low quality of available evidence and suggest coordinating research through a national approach to address the problems.
[Yes]

P27
Quotes: "Marian Knight is funded by a National Institute for Health Research Professorship. This article presents independent research partly funded by the National Institute for Health Research (http:// www.nihr.ac.uk/Pages/default.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."
Reasoning: The authors describe the sources of funding for the systematic review and the role of the funders.
[Yes]

65. Alzahem 2011: Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis

LLM response

22 quote(s) from publication full text (mean similarity 99%)

A1
Quote: "The search strategy is summarized in Fig. 1. All potential publications from Medline (1950–June 2010), Embase (1980–June 2010), The Cochrane Library (issue 2, 2010) and ongoing trials through http://www.clinicaltrials.gov website were identified."
Reasoning: The research question and inclusion criteria were established before conducting the review by searching multiple databases.
[Yes]

A2
No relevant quotes found.
Reasoning: There is no mention of duplicate study selection and data extraction or a consensus procedure for disagreements.
[No]

A3
Quote: "The search strategy is summarized in Fig. 1. All potential publications from Medline (1950–June 2010), Embase (1980–June 2010), The Cochrane Library (issue 2, 2010) and ongoing trials through http://www.clinicaltrials.gov website were identified."
Reasoning: At least two electronic databases were searched (Medline, Embase, Cochrane Library) along with the clinicaltrials.gov website.
[Yes]

A4
No relevant quotes found.
Reasoning: There is no mention of including grey literature or unpublished studies as an inclusion criterion.
[No]

A5
Quote: "Forty-four articles were reviewed in full texts. Thirty-four articles were met the predefined inclusion criteria (Fig. 1)."
Reasoning: A flow diagram is provided showing the number of included and excluded studies at each stage.
[Yes]

A6
Quote: "Table 1 Comparative studies reporting laparoscopic inguinal hernia repair in infants and children"
Reasoning: Characteristics of the included studies are provided in an aggregated table format.
[Yes]

A7
Quote: "The quality of the included comparative studies was assessed independently by two authors. The Cochrane Collaboration criteria for randomized controlled trials was utilized (randomization, allocation concealment, blinding and completeness of follow-up). Cohort studies were assessed using the Newcastle-Ottawa Quality Assessment Scale [18]."
Reasoning: The methodological quality of included studies was independently assessed using the Cochrane criteria for RCTs and the Newcastle-Ottawa scale for cohort studies.
[Yes]

A8
Quote: "Although the data is limited, the laparoscopic approach was associated with a trend towards higher recurrence rate. A sensitivity analysis had shown a comparable recurrence rate among groups, where studies limited to infants, or addressing incarcerated hernia, or having a short follow-up period were excluded."
Reasoning: The results of the methodological quality assessment were considered in the analysis and conclusions, with a sensitivity analysis performed excluding lower quality studies.
[Yes]

A9
Quote: "Heterogeneity was defined as a significant test of heterogeneity (p < 0.1) and/or differences in the treatment effects across studies."
Reasoning: Heterogeneity was assessed to determine the appropriateness of pooling study results.
[Yes]

A10
No relevant quotes found.
Reasoning: There is no mention of assessing publication bias through funnel plots or statistical tests. However, with fewer than 10 studies, this assessment may not have been feasible.
[NA]

A11
No relevant quotes found.
Reasoning: Sources of support and conflict of interest are not clearly acknowledged for both the systematic review itself and each included study.
[No]

P1
Quote: "Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis"
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2
Quote: See structured abstract on page 1 of full text.
Reasoning: A structured abstract is provided with labeled sections for background, methods, results, and conclusions.
[Yes]

P3
Quote: "Inguinal hernia repair is one of the most frequently performed pediatric surgical operations [1]. Open repair of an inguinal hernia has been accepted as the method of choice since it was first described more than 50 years ago due to its lower morbidity, good cosmesis, and lower rates of recurrence [2–4]."
Reasoning: The rationale for the review is described in the context of what is already known about inguinal hernia repair in children.
[Yes]

P4
Quote: "Purpose To undertake a meta-analysis of comparative data of laparoscopic versus open inguinal herniotomy in infants and children."
Reasoning: The purpose statement specifies the population (infants and children), intervention (laparoscopic herniotomy), and comparison (open herniotomy).
[Yes]

P5
No relevant quotes found.
Reasoning: There is no mention of a review protocol or registration number.
[No]

P6
Quote: "Inclusion criteria All comparative studies of the laparoscopic and open approaches for indirect inguinal hernia in children aged less than 19 years were selected. The primary outcome measure was the recurrence rate."
Reasoning: The inclusion criteria specifies the study design (comparative studies), population (children <19 years old), and primary outcome (recurrence rate).
[Yes]

P7
Quote: "The search strategy is summarized in Fig. 1. All potential publications from Medline (1950–June 2010), Embase (1980–June 2010), The Cochrane Library (issue 2, 2010) and ongoing trials through http://www.clinicaltrials.gov website were identified."
Reasoning: Information sources searched are described, including databases with years of coverage and the clinicaltrials.gov website.
[Yes]

P8
No relevant quotes found.
Reasoning: The full search strategy is not presented for any of the databases searched.
[No]

P9
Quote: "Forty-four articles were reviewed in full texts. Thirty-four articles were met the predefined inclusion criteria (Fig. 1)."
Reasoning: The study selection process is described and shown in a flow diagram.
[Yes]

P10
Quote: "Data extraction Retrieved articles were assessed for eligibility and data on patients, intervention, control, outcomes and methodological quality were abstracted independently by two authors. Discrepancies were resolved by discussion and consensus."
Reasoning: The data extraction process is described, including independent extraction by two authors with resolution of discrepancies by consensus.
[Yes]

P11
No relevant quotes found.
Reasoning: There is no comprehensive list of all variables for which data were sought.
[No]

P12
Quote: "The quality of the included comparative studies was assessed independently by two authors. The Cochrane Collaboration criteria for randomized controlled trials was utilized (randomization, allocation concealment, blinding and completeness of follow-up). Cohort studies were assessed using the Newcastle-Ottawa Quality Assessment Scale [18]."
Reasoning: The methods for assessing risk of bias in individual studies are described, using Cochrane criteria for RCTs and Newcastle-Ottawa scale for cohort studies.
[Yes]

P13
Quote: "For dichotomous outcomes, odds ratio (OR) and its associated confidence interval were calculated. For continuous outcomes, treatment effect was expressed as mean difference and its calculated standard deviation."
Reasoning: The principal summary measures of odds ratio for dichotomous outcomes and mean difference for continuous outcomes are stated.
[Yes]

P14
Quote: "Heterogeneity was defined as a significant test of heterogeneity (p < 0.1) and/or differences in the treatment effects across studies."
Reasoning: Methods for assessing heterogeneity are described.
[Yes]

P15
No relevant quotes found.
Reasoning: There is no mention of methods for assessing risk of bias that may affect the cumulative evidence, such as publication bias or selective reporting.
[No]

P16
Quote: "A sensitivity analysis was conducted where studies limited to girls, and/or with a median follow-up less than 6 months, and/or addressing a complicated hernia, and/or limited to infants were excluded and the meta-analysis of the remaining 6 comparative studies had shown a comparable recurrence rate among the groups [OR = 0.87; 95% CI 0.34–2.23; p = 0.76] (Fig. 2b)."
Reasoning: Additional sensitivity analyses were performed, excluding certain studies based on specific criteria.
[Yes]

P17
Quote: "Forty-four articles were reviewed in full texts. Thirty-four articles were met the predefined inclusion criteria (Fig. 1)."
Reasoning: A flow diagram is provided showing the number of studies screened, assessed for eligibility, and included, with reasons for exclusions at each stage.
[Yes]

P18
Quote: "Table 1 Comparative studies reporting laparoscopic inguinal hernia repair in infants and children"
Reasoning: A table is provided showing the characteristics of each included study along with citations.
[Yes]

P19
Quote: "The quality of the included comparative studies was assessed independently by two authors. The Cochrane Collaboration criteria for randomized controlled trials was utilized (randomization, allocation concealment, blinding and completeness of follow-up). Cohort studies were assessed using the Newcastle-Ottawa Quality Assessment Scale [18]."
Reasoning: The methodological quality assessment for each included study is described in the text, though the individual study quality scores are not presented.
[Yes]

P20
Quote: "Fig. 2 a Forest plot comparing recurrence rate for children treated with laparoscopic versus open inguinal herniotomy. b Sensitivity analysis of recurrence rate among children treated by laparoscopic versus open inguinal herniotomy"
Reasoning: Forest plots are provided showing the odds ratio and 95% confidence interval for the primary outcome of recurrence rate for each study.
[Yes]

P21
Quote: "Fig. 2 a Forest plot comparing recurrence rate for children treated with laparoscopic versus open inguinal herniotomy. b Sensitivity analysis of recurrence rate among children treated by laparoscopic versus open inguinal herniotomy"
Reasoning: Forest plots showing the pooled odds ratio and 95% confidence interval are provided for the meta-analyses.
[Yes]

P22
No relevant quotes found.
Reasoning: There is no presentation of results assessing risk of bias across studies, such as a funnel plot for publication bias.
[No]

P23
Quote: "A sensitivity analysis was conducted where studies limited to girls, and/or with a median follow-up less than 6 months, and/or addressing a complicated hernia, and/or limited to infants were excluded and the meta-analysis of the remaining 6 comparative studies had shown a comparable recurrence rate among the groups [OR = 0.87; 95% CI 0.34–2.23; p = 0.76] (Fig. 2b)."
Reasoning: The results of the sensitivity analyses are reported.
[Yes]

P24
Quote: "Our review examined the safety and efficacy of the laparoscopic approach in the management of inguinal hernias in infants and children. Ten comparative studies were reviewed. Although the data is limited, the laparoscopic approach was associated with a trend towards higher recurrence rate."
Reasoning: The main findings are summarized, including the trend towards higher recurrence with the laparoscopic approach based on limited data from the included studies.
[Yes]

P25
Quote: "Although our review utilized a very comprehensive search strategy to minimize the effect of publication bias, only two randomized clinical trial was included. Therefore, our review is a summary of the existing evidence with limitation to the conclusions drawn from these data due to the quality of the included studies."
Reasoning: Limitations of the review are discussed, including the small number of randomized trials and overall limited quality of evidence from the included studies.
[Yes]

P26
Quote: "Recurrent groin hernias can be due to various defects and minimal access surgery is the best method for their detection and simultaneous repair [31]. Laparoscopic repair seems to be the preferred method for recurrent hernia after open repair, with less chance of damage to vas or testicular vessels by going through a virgin territory, and scattered case series have shown its comparability to an initial laparoscopic repair [32, 33]."
Reasoning: The conclusions provide a general interpretation in the context of other evidence regarding laparoscopic repair for recurrent hernias, with implications for future practice.
[Yes]

P27
No relevant quotes found.
Reasoning: Sources of funding for the systematic review are not described.
[No]

66. Apelt 2013: Laparoscopic treatment of intussusception in children: A systematic review

LLM response

20 quote(s) from publication full text (mean similarity 99.9%)

A1
Quote: "We thus aimed to provide the data needed to challenge current clinical practice in favor of a method that allows for earlier discharge, reduced postoperative pain and decreased risk for postoperative SBO."
Reasoning: The authors stated their research objective, but did not refer to a protocol or pre-determined inclusion criteria.
[No]

A2
No relevant quotes found.
Reasoning: The authors did not mention using at least two independent reviewers for study selection and data extraction.
[No]

A3
Quotes: "An online database search for all English language articles on pediatric small bowel obstruction, intussusception and laparoscopy in PubMed, Medline and Ovid from January 1990 to April 2012 was performed. Results were confirmed by a second independent search by a different member of the team using matching search strings and databases."
Reasoning: At least two databases were searched and the search was confirmed by a second independent researcher.
[Yes]

A4
Quote: "Exclusion criteria were non-English language articles, case reports, laparoscopic-assisted enema reduction and mixed pediatric and adult populations (age cutoff 18 years)."
Reasoning: The authors specified exclusion criteria but did not explicitly mention including grey literature.
[No]

A5
Quote: "Fig. 1 Algorithm for the studies selection (based on PRISMA guidelines)."
Reasoning: A flow diagram of included and excluded studies was provided.
[Yes]

A6
Quote: "Table 1 Summary data of the selected studies included in the systematic review."
Reasoning: Characteristics of the included studies were provided in an aggregated table.
[Yes]

A7
Quotes: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
"Postoperative complications occurred in eight children, one of which suffered a postoperative intestinal perforation (Table 2)."
Reasoning: The scientific quality of individual studies was not formally assessed. Some complications were reported but not systematically.
[No]

A8
No relevant quotes found.
Reasoning: The authors did not assess study quality, so they could not have used it appropriately in formulating conclusions.
[No]

A9
Quote: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
Reasoning: A meta-analysis was not performed due to study heterogeneity.
[NA]

A10
No relevant quotes found.
Reasoning: The likelihood of publication bias was not assessed.
[NA]

A11
No relevant quotes found.
Reasoning: Sources of funding or conflicts of interest were not reported for the systematic review or included studies.
[No]

P1
Quote: "Laparoscopic treatment of intussusception in children: A systematic review"  
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2
Quote: "Background: Idiopathic intussusception is one of the most common causes of small bowel obstruction in children. In the event of failed radiological reduction, laparotomy remains the treatment of choice. There is still no agreement in pediatric surgery about safety and effectiveness of the use of minimally invasive surgery in this common pediatric condition. By reviewing available data we aimed to establish whether laparoscopy should be the primary technique in the surgical reduction of intussusception."
Reasoning: The abstract provides a structured summary including background, objectives, methods, results and conclusion.
[Yes]  

P3
Quote: "Idiopathic intussusception is the single most common cause of small bowel obstruction in children younger than 5 years [1,2]. Radiological reduction of intussusception (air or saline enema) is the first-line treatment and it is successful"
Reasoning: The introduction describes the rationale for the review in the context of what is already known about intussusception in children.
[Yes]

P4
Quote: "We thus aimed to provide the data needed to challenge current clinical practice in favor of a method that allows for earlier discharge, reduced postoperative pain and decreased risk for postoperative SBO."
Reasoning: The objectives are stated, but do not explicitly reference the PICOS framework.
[No]

P5
No relevant quotes found.
Reasoning: The authors did not mention the existence of or access to a review protocol.
[No]

P6
Quotes: "Exclusion criteria were non-English language articles, case reports, laparoscopic-assisted enema reduction and mixed pediatric and adult populations (age cutoff 18 years)."
Reasoning: The authors specified the study characteristics and report characteristics used as eligibility criteria.
[Yes]

P7
Quote: "An online database search for all English language articles on pediatric small bowel obstruction, intussusception and laparoscopy in PubMed, Medline and Ovid from January 1990 to April 2012 was performed."
Reasoning: The information sources and dates of coverage were described.
[Yes]

P8
No relevant quotes found.
Reasoning: The full electronic search strategy was not presented.
[No]

P9
Quote: "Fig. 1 Algorithm for the studies selection (based on PRISMA guidelines)."
Reasoning: A flow diagram illustrates the process of study screening and selection.
[Yes]

P10
No relevant quotes found.
Reasoning: The method of data extraction was not described.
[No]

P11
No relevant quotes found.
Reasoning: The data items collected were not defined.
[No]

P12
No relevant quotes found.
Reasoning: The authors did not describe methods for assessing risk of bias in individual studies.
[No]

P13
Quote: "Statistical means were compared and weighed according to total (n) cases using Student's t test and assumed normal distribution."
Reasoning: The statistical methods used to compare means were described.
[Yes]

P14
Quote: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
Reasoning: A meta-analysis was not performed.
[NA]

P15
No relevant quotes found.
Reasoning: Risk of bias across studies was not assessed.
[NA]

P16
No relevant quotes found.
Reasoning: Additional analyses were not described.
[NA]

P17
Quote: "Fig. 1 Algorithm for the studies selection (based on PRISMA guidelines)."
Reasoning: A flow diagram provides the numbers of studies screened, assessed for eligibility, included and excluded.
[Yes]

P18
Quote: "Table 1 Summary data of the selected studies included in the systematic review."
Reasoning: Study characteristics and citations were provided for each included study.
[Yes]

P19
No relevant quotes found.
Reasoning: Risk of bias assessments for individual studies were not presented.
[No]

P20
Quote: "Table 1 Summary data of the selected studies included in the systematic review."
Reasoning: The table provides some outcome data for individual studies but not effect estimates and confidence intervals.
[No]

P21
No relevant quotes found.
Reasoning: A meta-analysis was not performed.
[NA]

P22
No relevant quotes found.
Reasoning: Risk of bias across studies was not assessed.
[NA]

P23
No relevant quotes found.
Reasoning: Additional analyses were not reported.
[NA]

P24
Quote: "A large number of pediatric and general surgeons consider laparotomy to be the unequivocal gold standard in the surgical treatment of intussusception."
Reasoning: The main findings are summarized and their relevance to key groups (pediatric surgeons) is considered.
[Yes]

P25
Quote: "Likewise, pediatric laparoscopy has been consistently associated with a significantly reduced length of stay compared to open surgery, regardless of primary pathology [7–10]. Even if the quality of data, about the difference in LOS between laparoscopic and open reduction of intussusception, is still weak, we believe that it is possible to speculate a shorter LOS after laparoscopy in light of the statistical significance obtained in Table 4 (4 vs. 7 days, p < 0.0001) and the previous pediatric laparoscopic literature [7–10]."
Reasoning: Limitations of the evidence base and review are discussed.
[Yes]

P26
Quote: "20 years of pediatric laparoscopic surgery and the contraindications for this relatively recent method continue to evolve, as do the discussions surrounding its use. The scarcity of available randomized controlled trials on the postoperative outcome of laparoscopy in children continues to hamper discussion, and so extrapolation from adult data oftentimes remains the only available option to evaluate new findings. It is in this light that we should aim to interpret the results obtained in this systematic review."
Reasoning: The authors provide a general interpretation of the results in the context of other evidence and discuss implications for future research.
[Yes]

P27
No relevant quotes found.
Reasoning: Sources of funding for the systematic review were not described.
[No]

67. Aworanti 2014: Management of Recurrent Tracheoesophageal Fistulas: A Systematic Review

LLM response

18 quote(s) from publication full text (mean similarity 98.7%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: The authors do not mention a protocol, ethics approval, or pre-determined objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "The data obtained included number of patients treated, treatment modality employed, effectiveness of each treatment modality, and the outcomes after treatment."
Reasoning: The authors do not state that at least two people independently selected studies and extracted data.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula. The index of all issues of the European Journal of Pediatric Surgery, Journal of Pediatric Surgery, Pediatric Surgery International, and the International Journal of Pediatric Otorhinolaryngology was searched for relevant articles; the reference list of all relevant articles was also searched. All English language articles published by August 2013, irrespective of descriptive form describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
Reasoning: The authors searched 3 databases and other relevant sources.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: "All English language articles published by August 2013, irrespective of descriptive form describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
Reasoning: The authors included articles irrespective of publication type.
[Yes]

A5. Was a list of studies (included and excluded) provided?
Quotes: None relevant.
Reasoning: The authors do not provide a list of included and excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: See Tables 1-4.
Reasoning: The authors provide aggregated data on patient characteristics, interventions, and outcomes in table format.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: None relevant.
Reasoning: The authors do not mention assessing the quality of included studies.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: None relevant.
Reasoning: The authors do not appear to consider study quality when drawing conclusions.
[No]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "A synthesis of the data is presented in a descriptive form due to the heterogeneity of the included articles."
Reasoning: The authors appropriately synthesized the data descriptively due to heterogeneity.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant.
Reasoning: The authors do not mention assessing publication bias.
[No]

A11. Was the conflict of interest included?
Quotes: None relevant.
Reasoning: The authors do not report sources of support for the review or included studies.
[No]

P1. Title
Quotes: "Management of Recurrent Tracheoesophageal Fistulas: A Systematic Review"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
Quotes: See the structured abstract on the first page.
Reasoning: The abstract has labeled sections covering background, methods, results and conclusions.
[Yes]  

P3. Introduction / Rationale
Quotes: "The spectrum of esophageal atresia (EA) and tracheoesophageal fistula (TEF) include an isolated EA, EA with a proximal and/or distal TEF and the "H" or "N" type fistula. Since the initial description of the open surgical repair1 and subsequent thoracoscopic approaches2,3 the outcomes have been very encouraging. Anastomotic leaks, esophageal strictures, gastroesophageal reflux, and tracheomalacia are complications pediatric surgeons are familiar with. The incidence of a fistula recurrence range from 1.9 to 11% after open and thoracoscopic repairs.2,4–8"
Reasoning: The introduction describes the background and rationale for the review.
[Yes]

P4. Introduction / Objectives
Quotes: "We aim to comparatively review all published treatment options, and outcomes, for managing RTEF."
Reasoning: The objectives are stated, but do not fully reference the PICOS.
[No]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: The authors do not mention a protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quotes: "All English language articles published by August 2013, irrespective of descriptive form describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
Reasoning: The authors specify the study characteristics used as eligibility criteria.
[Yes]

P7. Methods / Information sources
Quotes: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula. The index of all issues of the European Journal of Pediatric Surgery, Journal of Pediatric Surgery, Pediatric Surgery International, and the International Journal of Pediatric Otorhinolaryngology was searched for relevant articles; the reference list of all relevant articles was also searched."
Reasoning: The authors describe the databases and other information sources searched.
[Yes]

P8. Methods / Search
Quotes: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula."
Reasoning: The authors provide the keywords used but not the full search strategy.
[No]

P9. Methods / Study selection
Quotes: "All English language articles published by August 2013, irrespective of descriptive form describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
Reasoning: The authors state the process for selecting studies.
[Yes]

P10. Methods / Data collection process
Quotes: "The data obtained included number of patients treated, treatment modality employed, effectiveness of each treatment modality, and the outcomes after treatment."
Reasoning: The authors describe the data that was extracted but not the method of extraction.
[No]

P11. Methods / Data items
Quotes: "The data obtained included number of patients treated, treatment modality employed, effectiveness of each treatment modality, and the outcomes after treatment."
Reasoning: The authors list the data items that were sought.
[Yes]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant.
Reasoning: The authors do not mention assessing risk of bias in individual studies.
[No]

P13. Methods / Summary measures
Quotes: None relevant.
Reasoning: The authors do not state the principal summary measures.
[No]

P14. Methods / Synthesis of results
Quotes: "A synthesis of the data is presented in a descriptive form due to the heterogeneity of the included articles."
Reasoning: The authors describe synthesizing the data descriptively due to heterogeneity.
[Yes]

P15. Methods / Risk of bias across studies
Quotes: None relevant.
Reasoning: The authors do not mention assessing risk of bias across studies.
[No]

P16. Methods / Additional analyses
Quotes: None relevant.
Reasoning: The authors do not mention any additional analyses.
[NA]

P17. Results / Study selection
Quotes: "A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS. Of the 57 ET patients, there was an 84% success rate compared with 93.5% of 108 OS patients; the failed ET cases were all successfully treated by OS."
Reasoning: The authors provide the number of studies and patients included but not the number screened or reasons for exclusions.
[No]

P18. Results / Study characteristics
Quotes: See Tables 1-4.
Reasoning: The authors present aggregated study characteristics in table format.
[Yes]

P19. Results / Risk of bias within studies
Quotes: None relevant.
Reasoning: The authors do not present data on risk of bias within studies.
[No]

P20. Results / Results of individual studies
Quotes: See Tables 1-4.
Reasoning: The authors present some individual study data in the tables.
[Yes]

P21. Results / Synthesis of results
Quotes: None relevant.
Reasoning: The authors did not perform a meta-analysis.
[NA]

P22. Results / Risk of bias across studies
Quotes: None relevant.
Reasoning: The authors did not assess risk of bias across studies.
[NA]

P23. Results / Additional analysis
Quotes: None relevant.
Reasoning: The authors did not perform any additional analyses.
[NA]

P24. Discussion / Summary of evidence
Quotes: "OS for RTEF has a low morbidity and mortality, a higher success rate, and requires fewer treatments than an endoscopic repair. The ideal ET is undecided but it remains a viable alternative provided treatment failures are anticipated and prompt redo treatments initiated to prevent ongoing respiratory morbidity."
Reasoning: The authors summarize the main findings.
[Yes]

P25. Discussion / Limitations
Quotes: "This finding should however be interpreted with caution due to the small numbers, particularly in the "sealant only" group (n = 6)."
Reasoning: The authors mention the limitation of small sample sizes in one comparison but do not discuss limitations at the review level.
[No]

P26. Discussion / Conclusions
Quotes: "Minimally invasive techniques are widely accepted to be better tolerated by patients and whenever possible such options should be explored, thus supporting the case for ET; however, the outcomes should be comparable. Several authors have used a variety of techniques for ET, summarized above, all hoping to achieve better outcomes. There have been three literature reviews on ET. In Hoelzer 1999 review,12 15 cases were reported, having been treated with diathermy, laser, n-BCA, and fibrin glue, and 1 to 5 treatments were necessary with complete closure in only 10 patients (67%). Meier et al in 200726 reported an overall success rate of 60% of 62 patients culled from the literature (fibrin glue 55% [n = 22], n-BCA 48% [n = 29], laser 80% [n = 5], diathermy 50% [n = 10], n-BCA + sealant100% [n = 5]); the mean number of applications ranged from 1 to 5.5. They concluded that ET is safe, effective, has less morbidity than OS and recommended fibrin glue but advised close follow-up. Richter et al28 in their 2008 review, culled 37 patients from the literature and categorized ET into: application of sealant only (n = 14; 78.6% success), de-epithelization of the fistula tract only (n = 8; 62.5% success), de-epithelization combined with sealant (n = 15; 93.3%). Overall there was an 81.1% success rate (48.6% after a single attempt) and they concluded that de-epithelization with diathermy combined with fibrin glue sealant will yield the best results; fibrin glue by nature would work better if the opening is small, as it is opposed and not stretched."
Reasoning: The authors provide an interpretation of the results in the context of previous literature reviews.
[Yes]

P27. Funding
Quotes: None relevant.
Reasoning: The authors do not describe sources of funding for the review.
[No]

68. Baker 2015: A systematic review and meta-analysis of gastrostomy insertion techniques in children

LLM response

23 quote(s) from publication full text (mean similarity 99.3%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: The text does not mention a protocol, ethics approval, or pre-determined research objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "Data extraction was conducted by 2 reviewers (LB & AB) using a predefined data extraction worksheet."
Reasoning: The text states data extraction was done in duplicate, but does not specify the same for study selection.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A systematic search of electronic databases was performed to identify all relevant studies comparing two or more gastrostomy insertion techniques in children reporting procedural-related complication rates. A reference librarian was consulted to assist with the development of database-specific search strategies. We used exploded Medical Subject Headings (MeSH) and keywords to search for the following themes: pediatrics, open gastrostomy, percutaneous endoscopic gastrostomy, interventional radiologically guided gastrostomy, and laparoscopic gastrostomy (Appendix 1 for detailed search strategy)."
Reasoning: At least 2 electronic databases were searched along with consultation with a librarian.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: The text does not mention searching for or including grey literature.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "Fig. 1. Consort diagram of articles included in review."
Reasoning: A flow diagram is provided showing the number of studies included and excluded at each stage.
[Yes]

A6. Were the characteristics of the included studies provided?
Quotes: "Table 1 Studies that met inclusion criteria, segregated by procedure. Complication rates and MINORS score are displayed."
Reasoning: A table provides the key characteristics of the included studies.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "The methodological index for non-randomized studies (MINORS) was utilized to determine the quality of studies and risk of bias [6]."
Reasoning: The MINORS tool was used to assess study quality and risk of bias.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "Despite being less invasive, this relatively blind approach has been associated with unique complications including placement of the catheter through a lobe of the liver and fistulation into the small bowel [9,10]. In 1990, laparoscopic gastrostomy placement was introduced, combining the minimally invasive advantages of PEG with the safety of the OPEN procedure allowing for tube placement under direct visualization."
Reasoning: The limitations of the included studies were considered when interpreting the results and drawing conclusions.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "The studies not described either failed to report a statistical analysis or did not comment on the above patient demographics."
Reasoning: The text indicates that a quantitative synthesis was not performed due to lack of reporting in the included studies.
[NA]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant.
Reasoning: Publication bias was not assessed, likely because a quantitative synthesis was not performed.
[NA]

A11. Was the conflict of interest included?
Quotes: None relevant.
Reasoning: The text does not report sources of funding or conflicts of interest for the systematic review or included studies.
[No]

P1. Title
Quotes: "A systematic review and meta-analysis of gastrostomy insertion techniques in children"
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quotes: The abstract contains labeled sections for Background, Methods, Results, and Conclusions.
Reasoning: The abstract is structured with the required sections.
[Yes]

P3. Introduction / Rationale
Quotes: "Gastrostomy tubes are inserted via multiple techniques to provide a route for enteral feeding in the pediatric population. This review compares the rate of major complications and resource utilization associated with the various insertion techniques."
Reasoning: The rationale for the review is provided in the context of current knowledge.
[Yes]

P4. Introduction / Objectives
Quotes: "The primary outcome of interest was postoperative complication requiring an operative procedure within one year - our working definition of a major complication."
Reasoning: The primary outcome is stated, but the full PICOS elements are not provided as a focused question.
[No]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quotes: "All studies that compared postoperative outcomes in two or more gastrostomy placement techniques in a pediatric population were included. The primary outcome of interest was postoperative complication requiring an operative procedure within one year - our working definition of a major complication."
Reasoning: The eligibility criteria for population, interventions, comparators, and primary outcome are provided.
[Yes]

P7. Methods / Information sources
Quotes: "A systematic search of electronic databases was performed to identify all relevant studies comparing two or more gastrostomy insertion techniques in children reporting procedural-related complication rates. A reference librarian was consulted to assist with the development of database-specific search strategies."
Reasoning: Electronic databases were searched and a librarian was consulted.
[Yes]

P8. Methods / Search
Quotes: "Appendix 1. Detailed search strategy for each database"
Reasoning: The full search strategy for multiple databases is provided in the appendix.
[Yes]

P9. Methods / Study selection
Quotes: "All titles and abstracts identified in the electronic database were independently screened for relevance and categorized as relevant, possibly relevant or irrelevant, based on our inclusion criteria. Manuscripts of articles categorized as either relevant or possibly relevant were retrieved for further evaluation."
Reasoning: The process for study selection is described.
[Yes]

P10. Methods / Data collection process
Quotes: "Data extraction was conducted by 2 reviewers (LB & AB) using a predefined data extraction worksheet. The following information was extracted from each article: title, authors, number of centers involved,"
Reasoning: Data extraction was done by 2 reviewers using a predefined worksheet.
[Yes]

P11. Methods / Data items
Quotes: "The following information was extracted from each article: title, authors, number of centers involved,"
Reasoning: The data items extracted are listed.
[Yes]

P12. Methods / Risk of bias in individual studies
Quotes: "The methodological index for non-randomized studies (MINORS) was utilized to determine the quality of studies and risk of bias [6]."
Reasoning: The MINORS tool was used to assess risk of bias in the included studies.
[Yes]

P13. Methods / Summary measures
Quotes: None relevant.
Reasoning: The text does not specify the planned summary measures.
[No]

P14. Methods / Synthesis of results
Quotes: Not applicable, no meta-analysis performed.
Reasoning: A quantitative synthesis was not performed.
[NA]

P15. Methods / Risk of bias across studies
Quotes: None relevant.
Reasoning: Methods for assessing risk of bias across studies are not mentioned, likely because a quantitative synthesis was not performed.
[NA]

P16. Methods / Additional analyses
Quotes: None relevant.
Reasoning: No additional analyses are mentioned.
[NA]

P17. Results / Study selection
Quotes: "Fig. 1. Consort diagram of articles included in review."
Reasoning: A flow diagram is provided detailing the study selection process.
[Yes]

P18. Results / Study characteristics
Quotes: "Table 1 Studies that met inclusion criteria, segregated by procedure. Complication rates and MINORS score are displayed."
Reasoning: Study characteristics are provided in Table 1.
[Yes]

P19. Results / Risk of bias within studies
Quotes: "Table 2 Comparison of studies investigating laparoscopic gastrostomy versus percutaneous endoscopic gastrostomy."
Reasoning: Table 2 provides the MINORS scores assessing risk of bias for each included study.
[Yes]

P20. Results / Results of individual studies
Quotes: "Table 1 Studies that met inclusion criteria, segregated by procedure. Complication rates and MINORS score are displayed."
Reasoning: The complication rates for each study are provided in Table 1.
[Yes]

P21. Results / Synthesis of results
Quotes: Not applicable, no meta-analysis performed.
Reasoning: A quantitative synthesis was not performed.
[NA]

P22. Results / Risk of bias across studies
Quotes: Not applicable, no meta-analysis performed.
Reasoning: Risk of bias across studies was not assessed, likely because a quantitative synthesis was not performed.
[NA]

P23. Results / Additional analysis
Quotes: Not applicable, no additional analyses mentioned.
Reasoning: No additional analyses were reported.
[NA]

P24. Discussion / Summary of evidence
Quotes: "Gastrostomy tube placement remains a highly popular intervention with a number of indications, in both adult and pediatric populations. Since initially introduced in 1986 as an open surgical approach, it has evolved into a procedure performed using multiple different techniques by several different operators, including surgeons, gastroenterologists, endoscopists and interventional radiologists."
Reasoning: The main findings are summarized.
[Yes]

P25. Discussion / Limitations
Quotes: "Selection of older, heavier children for the open procedure may be explained by the lack of evidence documenting safety of PEG in infants at the time of study completion. The first large pediatric review of PEG in small (<6 kg) neonates with failure to thrive was in 2011 [38]. As there is currently no literature supporting patient age or weight as a predictive factor for success and safety of tube placement, we are unable to draw conclusions on the influence of these discrepancies of baseline demographics on the results."
Reasoning: Limitations at the study and review level are discussed.
[Yes]

P26. Discussion / Conclusions
Quotes: "The most commonly reported disadvantages of LAP over PEG are increased operative length and cost. Three of the 10 comparative studies commented on operative length, 2 of which reported a statistically significant decrease in operative time in the PEG group compared to LAP. However, Zamakhshary et al. [11] reported cumulative operative time (for the PEG group including conversion to low-profile button under general anesthesia) and reported no significant difference in operative length between the two techniques when this conversion was accounted for (54.4 minutes LAP versus 53.7 minutes PEG). Only one investigation commented on the discrepancy in direct costs between the two insertion techniques. On average, the procedure-related hospital charges during an LAP insertion visit were found to be $1050 higher than in PEG. Given that the study is single institutional and now 10 years out of date, these absolute cost numbers are likely inaccurate and hard to generalize. Increased operative time secondary to inexperience with laparoscopic equipment was the primary contributor to the increased cost affiliated with LAP."
Reasoning: The conclusions provide an interpretation of the results in the context of other evidence and implications.
[Yes]

P27. Funding
Quotes: None relevant.
Reasoning: Sources of funding for the systematic review are not reported.
[No]

69. Berger 2012: Mitomycin C in the Therapy of Recurrent Esophageal Strictures: Hype or Hope?

LLM response

14 quote(s) from publication full text (mean similarity 99.7%)

A1
Quote: "The current literature was screened for publications regarding the application of Mitomycin C in esophageal stenosis and stricture with special emphasis on pediatric data."
Reasoning: The authors mention screening the literature for publications on the topic, implying an a priori design.
[Yes]

A2
No relevant quotes found.
Reasoning: The authors do not mention duplicate study selection and data extraction.
[No]

A3
Quotes: "The current literature was screened for publications regarding the application of Mitomycin C in esophageal stenosis and stricture with special emphasis on pediatric data. The screen included the use of Mitomycin C in other subspecialties such as ophthalmology; ear, nose, and throat surgery; as well as animal models."
Reasoning: The authors searched the literature and included multiple subspecialties and animal models, indicating a comprehensive search.
[Yes]

A4
No relevant quotes found.
Reasoning: The authors do not specify whether they included grey literature.
[No]

A5
No relevant quotes found.
Reasoning: The authors do not provide a list of included and excluded studies.
[No]

A6
Quote: "Table 1 displays the variety of Mitomycin C application. By combining the keyword "Mitomycin C" with "eye" or "airway" more than 1400 PubMed publications were detected. When "Mitomycin C" was linked with "esophagus," 95 studies were appreciated."
Reasoning: The authors provide some aggregated data on the included studies in Table 1, but do not give detailed characteristics.
[No]

A7
No relevant quotes found.
Reasoning: The authors do not mention assessing the quality of included studies.
[No]

A8
[NA] - Quality assessment of included studies was not performed (A7).

A9
[NA] - The review does not appear to include a meta-analysis or quantitative synthesis.

A10
[NA] - The review does not appear to include a meta-analysis or quantitative synthesis.

A11
No relevant quotes found.
Reasoning: The authors do not report on sources of funding or conflicts of interest for the included studies.
[No]

P1
Quote: "Mitomycin C in the Therapy of Recurrent Esophageal Strictures: Hype or Hope?"  
Reasoning: The title identifies the article as a review on the use of mitomycin C for esophageal strictures.
[Yes]

P2
No relevant quotes found.
Reasoning: The article does not contain a structured abstract with the required sections.
[No]

P3
Quote: "For centuries, esophageal strictures have been recognized as an important health problem in children.1–3 The etiology includes surgery for malformations of the foregut such as esophageal atresia (EA) and tracheoesophageal fistula (TEF), the ingestion of caustic agents, severe gastroesophageal reflux, and other disease entities."
Reasoning: The introduction provides rationale by discussing the background and importance of esophageal strictures in children.
[Yes]

P4
No relevant quotes found.
Reasoning: The introduction does not provide an explicit statement of the review questions being addressed.
[No]

P5
No relevant quotes found.
Reasoning: The authors do not mention the existence of or access to a review protocol.
[No]

P6
No relevant quotes found.
Reasoning: The authors do not specify detailed inclusion/exclusion criteria for the review.
[No]

P7
Quote: "The current literature was screened for publications regarding the application of Mitomycin C in esophageal stenosis and stricture with special emphasis on pediatric data."
Reasoning: The authors describe their literature search but do not provide details on information sources and dates.
[No]

P8
No relevant quotes found.
Reasoning: The authors do not present the full search strategy used.
[No]

P9
No relevant quotes found. 
Reasoning: The study selection process is not described in detail.
[No]

P10
No relevant quotes found.
Reasoning: The data collection process is not described.
[No]

P11
No relevant quotes found.
Reasoning: The authors do not provide a list of the variables for which data were sought.
[No]

P12
No relevant quotes found.
Reasoning: Risk of bias assessment methods for individual studies are not described.
[No]

P13
[NA] - The review does not appear to include a meta-analysis or quantitative synthesis.

P14
[NA] - The review does not appear to include a meta-analysis or quantitative synthesis.

P15
[NA] - The review does not appear to include a meta-analysis or quantitative synthesis.

P16
[NA] - The review does not appear to include a meta-analysis or quantitative synthesis.

P17
No relevant quotes found.
Reasoning: The authors do not provide a flow diagram or details on the number of studies screened and included.
[No]

P18
Quote: "Table 2 Overview on Existing Literature—Patient's Age, Etiology, and Morphology of Esophageal Stricture and Stenosis"
Reasoning: Table 2 provides some characteristics of the included studies along with citations.
[Yes]

P19
[NA] - Risk of bias assessment of individual studies was not performed (P12).

P20
No relevant quotes found.
Reasoning: The authors do not present effect estimates and confidence intervals for each study.
[No]  

P21
[NA] - The review does not appear to include a meta-analysis or quantitative synthesis.

P22
[NA] - The review does not appear to include a meta-analysis or quantitative synthesis.

P23 
[NA] - The review does not appear to include a meta-analysis or quantitative synthesis.

P24
Quote: "The early results of topical Mitomycin C application for the treatment of severe, recurrent esophageal strictures refractory to repeated balloon dilations are encouraging. The application of Mitomycin C, at short follow-up, was shown to be safe, and no complications or dysplasia were acknowledged."
Reasoning: The discussion summarizes the main findings on the safety and short-term efficacy of mitomycin C for esophageal strictures.
[Yes]

P25
Quote: "Although the etiology causing the stenosis was very heterogeneous, all children were homogenous in that repeated dilations did not show improvement and that none had previously been treated with Mitomycin C."
Reasoning: The authors acknowledge a limitation in the heterogeneity of the included patients.
[Yes]

P26
Quote: "Questions not yet answered include technical aspects of the proper and safe way of application, the optimal indication, time point of initial treatment, dosage, as well as the number of applications. All patients who undergo topical application of Mitomycin C for esophageal structures should be included in long-term follow-up programs."
Reasoning: The authors provide a general interpretation and discuss implications for future research.
[Yes]

P27
Quote: "M. Berger was supported by the German Academic Exchange Service (DAAD, Deutscher Akademischer Austauschdienst)."
Reasoning: The authors report a funding source for the review.
[Yes]

70. Billingham 2010: Pediatric Surgical Technique: Laparoscopic or Open Approach? A systematic Review and Meta-Analysis

LLM response

22 quote(s) from publication full text (mean similarity 96.9%)

A1 - Was an 'a priori' design provided?
Quote: "A computerized comprehensive search supplemented by a manual review of the literature was performed for all peer-reviewed publications comparing laparoscopic and open appendectomy, fundoplication and hernia repair cohorts."
The authors mention performing a comprehensive literature search, but do not specify an a priori protocol or predetermined objectives.
[No]

A2 - Was there duplicate study selection and data extraction? 
No relevant quotes found. The authors do not mention any duplicate study selection or data extraction process.
[No]

A3 - Was a comprehensive literature search performed?
Quote: "To complete this study a comprehensive literature review was conducted. All available electronic databases including the British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIOSIS Previews, ISI Web of Knowledge, ISI Web of Science and IngentaConnect, were systematically searched for each procedure, between the period 1992–2009 for all English and non-English language articles."
The authors searched multiple electronic databases comprehensively.
[Yes]

A4 - Was the status of publication (i.e. grey literature) used as an inclusion criterion?
No relevant quotes found. The authors do not mention including or excluding studies based on publication status or grey literature.
[No]

A5 - Was a list of studies (included and excluded) provided?
Quote: "A total of 24 articles were identified that met the search and inclusion criteria."
The authors report the total number of included studies but do not provide a list of included and excluded studies.
[No]

A6 - Were the characteristics of the included studies provided?
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
The authors provide key characteristics of the included studies in an aggregated table.
[Yes] 

A7 - Was the scientific quality of the included studies assessed and documented?
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
The authors assessed study quality and provided the ratings in Table 1.
[Yes]

A8 - Was the scientific quality of the included studies used appropriately in formulating conclusions?
No relevant quotes found. The authors do not appear to consider study quality when formulating the conclusions of the review.
[No]

A9 - Were the methods used to combine the findings of studies appropriate?
Quotes: "Meta-analysis was conducted using weighted mean differences (WMD) as the summary statistic, comparing the laparoscopic treatment groups with the reference (open surgery) groups using the Mantel-Haenszel method."
"A negative WMD (less than 0) favored the laparoscopic treatment group, and the point estimate of the WMD was considered statistically significant at the p<0.05 level if the 95% confidence interval did not include the value zero."
The authors used appropriate meta-analytic methods to combine the results.
[Yes]

A10 - Was the likelihood of publication bias assessed?
No relevant quotes found. The authors do not mention assessing publication bias.
[No]

A11 - Was the conflict of interest included?
No relevant quotes found. The authors do not report sources of funding or conflicts of interest for the review or included studies.
[No]

P1 - Title
Quote: "Pediatric Surgical Technique: Laparoscopic or Open Approach? A systematic Review and Meta-Analysis"  
The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2 - Abstract / Structured summary
The abstract is structured with labeled sections for Introduction, Method/Design, Results, and Conclusion, covering the key elements.
[Yes]

P3 - Introduction / Rationale
Quote: "As in adult surgery, laparoscopy has become an integral part of pediatric surgical practice [6–8,18]. One study in 1998 surveyed pediatric surgeons in the United States and Canada to determine the extent of incorporation of laparo-scopic techniques into their practice, with an estimated 82% of surgeons utilizing this approach [6]."
The authors describe the rationale for the review in the context of the increasing use of laparoscopy in pediatric surgery.
[Yes]

P4 - Introduction / Objectives
Quote: "The laparoscopic treatment of pediatric populations remains controversial. In order to evaluate the clinical and cost-effectiveness of this surgical approach a number of outcome measures for laparoscopic and open techniques were analyzed in a comparative fashion."
The objectives are stated, although without explicit reference to PICOS elements.
[Yes]

P5 - Methods / Protocol and registration
No relevant quotes found. The authors do not mention a published protocol or registration number.
[No]

P6 - Methods / Eligibility criteria
Quote: "Given the breadth of minimally invasive procedures performed in practice, this review focused on three specific procedures for which outcome data exists: Laparoscopic appendectomy, Laparoscopic fundoplication (anti-reflux procedure) and Laparoscopic inguinal hernia repair."
The authors specify the procedures of interest but do not fully describe the eligibility criteria in terms of PICOS.
[No]

P7 - Methods / Information sources
Quote: "To complete this study a comprehensive literature review was conducted. All available electronic databases including the British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIOSIS Previews, ISI Web of Knowledge, ISI Web of Science and IngentaConnect, were systematically searched for each procedure, between the period 1992–2009 for all English and non-English language articles."
The authors describe the electronic databases searched and date ranges.
[Yes]

P8 - Methods / Search
Quote: "The keywords used during the search were: "endoscopic surgery, fundoplication, appendectomy and appendectomy, inguinal hernia, outcomes, minimally invasive surgery, laparoscopy, endoscopy, laparotomy, open surgery, effectiveness, costs, cost-effectiveness, paediatric and pediatric, infant and neonate". No limits were used. Further searches were performed to obtain articles from the bibliographic sections of the studies identified from the original electronic database search."
The authors provide the keywords used for the search but not the full search strategies.
[No]

P9 - Methods / Study selection
Quote: "A total of 24 articles were identified that met the search and inclusion criteria."
The number of included studies is reported but the selection process is not described in detail.
[No]  

P10 - Methods / Data collection process
No relevant quotes found. The data collection process is not described.
[No]

P11 - Methods / Data items
Quote: "These outcome measures included: Length of stay (LOS) after the procedure, Operating room (OR) time, Frequency of postoperative complications and Total hospital costs."
The authors list the outcome variables that data was sought for.
[Yes]

P12 - Methods / Risk of bias in individual studies
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
The authors assessed study quality which relates to risk of bias.
[Yes]

P13 - Methods / Summary measures
Quote: "Meta-analysis was conducted using weighted mean differences (WMD) as the summary statistic, comparing the laparoscopic treatment groups with the reference (open surgery) groups using the Mantel-Haenszel method."
The authors specify the principal summary measure (weighted mean difference).
[Yes]

P14 - Methods / Synthesis of results 
Quote: "Meta-analysis was conducted using weighted mean differences (WMD) as the summary statistic, comparing the laparoscopic treatment groups with the reference (open surgery) groups using the Mantel-Haenszel method."
The meta-analysis methods are described.
[Yes]

P15 - Methods / Risk of bias across studies
No relevant quotes found. Assessment of risk of bias across studies, such as publication bias, is not mentioned.
[No]

P16 - Methods / Additional analyses
No relevant quotes found. No additional analyses are mentioned.
[NA]

P17 - Results / Study selection
Quote: "A total of 24 articles were identified that met the search and inclusion criteria."
The number of included studies is provided but a flow diagram is not included.
[No]

P18 - Results / Study characteristics
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
Study characteristics are provided in an aggregated table.
[Yes]

P19 - Results / Risk of bias within studies
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
Results of the study quality assessment are reported in Table 1.
[Yes]

P20 - Results / Results of individual studies
Quotes: "Individual study LOS and OR time outcome data for laparoscopic and open appendectomy procedures are summarized in Fig. 1, 2, respectively."
"Of the 16 studies, 13 measured LOS and 12 showed a reduction in LOS for the laparoscopic group ranging from 0.1 to 5.5 days; only 1 study reported an increase for the LA group of 1 day."
Forest plots and a narrative summary are provided for the individual study results on key outcomes.
[Yes]

P21 - Results / Synthesis of results
Quote: "Meta-analysis was conducted using weighted mean differences (WMD) as the summary statistic, comparing the laparoscopic treatment groups with the reference (open surgery) groups using the Mantel-Haenszel method."
Meta-analysis results are reported, including forest plots with confidence intervals and p-values.
[Yes]

P22 - Results / Risk of bias across studies
No relevant quotes found. Results of any assessment of risk of bias across studies are not reported.
[NA]

P23 - Results / Additional analysis
No relevant quotes found. No additional analyses were mentioned.
[NA]

P24 - Discussion / Summary of evidence
Quote: "Clearly, LOS is significantly reduced in favor of the laparoscopic approach, with an overall weighted mean difference for LOS of −1.44 days (95% CI, −1.89 to −0.99, p<0.001), although the OR time is significantly increased, with a weighted mean difference of +12.8 min (95% CI, +3.7 to +21.9, p=0.006), favoring the open surgical technique."
The authors summarize the main findings for the key outcomes.
[Yes]

P25 - Discussion / Limitations
Quote: "The validity of the results of this review largely depends on the validity of the included studies. Many of the included studies failed to take all the steps necessary to avoid bias. There may well be an inherent bias in the analyses, which are likely to favor the 'newer' MIS/laparoscopic technique. The study will tend to select series performed by surgeons confident with MIS, whose results may not be suitable for generalizations. Those less confident/happier with conventional techniques may fare better doing 'what they know'. The only way of ensuring confidence in our findings would be by only including combination trials (ideally crossover)."
The authors discuss several important limitations of the review.
[Yes]

P26 - Discussion / Conclusions
Quote: "This review strengthens the use of MIS in pediatric populations, demonstrating that the three laparoscopic procedures reviewed showed better patient outcomes compared to open procedures in the form of reduced LOS and complication rates."
The authors provide a general interpretation of the results.
[Yes]

P27 - Funding
No relevant quotes found. Sources of funding for the systematic review are not reported.
[No]

71. Black 2013: Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis

LLM response

24 quote(s) from publication full text (mean similarity 96.1%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: No mention of a protocol, ethics approval, or a priori objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quote: "Two additional papers were included from references (n = 2)"
Reasoning: Implies at least study selection was done in duplicate.
[Yes]

A3. Was a comprehensive literature search performed?
Quotes: "The indexed reference libraries EMBASE and Medline were searched between January 1955 and January 2013 using the search terms presented in Table 1, using mapped and exploded terms. Additionally, the references of all included studies, the Cochrane Library and the titles of papers published in the journal Obesity Surgery from January 1992 till January 2013 were searched. Only papers written in English were retrieved."
Reasoning: At least 2 databases plus reference checking and additional sources were searched.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quote: "A total of 2303 unique citations were returned by the search strategy (Fig. 1). Of these, 2185 were excluded based on abstract review. Two additional papers were included from references (n = 2)"
Reasoning: A flow diagram with numbers of included and excluded studies was provided, but not a full list.
[No]

A6. Were the characteristics of the included studies provided?
Quote: "In total, 637 patients from 23 studies were included in the meta-analysis. There were significant decreases in BMI at 1 year (average weighted mean BMI difference: −13.5 kg m−2; 95% confidence interval [CI] −14.1 to −11.9). Complications were inconsistently reported. There was some evidence of co-morbidity resolution and improvements in HRQoL post-surgery."
Reasoning: Some aggregate characteristics were provided but not in table format for each study.
[No]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: "We also conducted a number of sensitivity analyses to examine whether change in BMI was effected by (i) the refinement of surgical techniques as publication date increased; (ii) gender and (iii) greater pre-surgery BMI."
Reasoning: Sensitivity analyses were conducted but no formal quality assessment of each study was reported.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Reasoning: Quality was not assessed (see A7), so could not be incorporated into conclusions.
[NA]

A9. Were the methods used to combine the findings of studies appropriate?
Quote: "Formulas outlined in the Cochrane Guidelines were used to derive necessary statistics or process individual data from each of the studies included in the meta-analysis (20). Median BMI estimates were not included in our review as variances are needed to meta-analyse data."
Reasoning: Appropriate methods were used to combine the studies.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant. 
Reasoning: Publication bias was not assessed.
[No]

A11. Was the conflict of interest included?
Quotes: None relevant.
Reasoning: Sources of funding for the review and included studies were not reported.
[No]

P1. Title
Quote: "Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis"
Reasoning: Identifies the report as a systematic review and meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quote: The abstract contains labeled Background, Methods, Results, and Conclusion sections summarizing the key elements.
Reasoning: Provides a structured summary with the required elements.
[Yes]

P3. Introduction / Rationale
Quote: "The global prevalence of obesity is rising in children and adolescents (1). In the United Kingdom, e.g. among individuals aged 11–15 years, the prevalence was 14.7% in 1995 and 18.3% in the 2010 round of the National Child Measurement Programme (2). The largest increases in body mass index (BMI) are seen in the top 5% of the BMI distribution (3). Treatment guidelines for obese children from National Institute for Health and Clinical Excellence (NICE) recommend lifestyle intervention support, assessment of co-morbidities, and referral to secondary care if morbidities are present (3,4). Children and adolescents for whom lifestyle change and standard clinical care are ineffective in reducing BMI are increasingly being considered for bariatric surgery, which encompasses a number of different surgical procedures (4)."
Reasoning: Describes the rationale for the review in the context of what is already known.
[Yes]

P4. Introduction / Objectives
Quote: "We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in BMI 1 year post-surgery and (iii) report complications, co-morbidity resolution and health-related quality of life (HRQoL)."
Reasoning: Provides an explicit statement of the review questions and inclusion criteria.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quote: "Examination of other gastric procedures, including VBG and jejunoileal bypass methods, were excluded as they are not currently recommended for use in paediatric populations (7,19). Study populations defined by specific causes of obesity were excluded. Because of the high possibility of selection bias, non-sequential case series and studies with less than 10 individuals were excluded. In non-randomized controlled trials (non-RCTs), only data from the surgical groups was considered."
Reasoning: Specifies the study characteristics and report characteristics used as eligibility criteria.
[Yes]

P7. Methods / Information sources
Quote: "The indexed reference libraries EMBASE and Medline were searched between January 1955 and January 2013 using the search terms presented in Table 1, using mapped and exploded terms. Additionally, the references of all included studies, the Cochrane Library and the titles of papers published in the journal Obesity Surgery from January 1992 till January 2013 were searched. Only papers written in English were retrieved."
Reasoning: Describes the databases searched and date last searched, plus additional information sources.
[Yes]

P8. Methods / Search
Quote: Table 1 provides the search terms used for EMBASE and Medline.
Reasoning: The full search strategy is provided for the two main databases.
[Yes]

P9. Methods / Study selection
Quote: "Studies were included if (i) they assessed BMI before and a minimum of six months after individuals predominately received AGB, RYGB, BPD or SG and (ii) the mean age of the population was between 6 and 18 years at study entry (18)."
Reasoning: States the process for selecting studies based on the eligibility criteria.
[Yes]

P10. Methods / Data collection process
Quote: "We used a standard data extraction method to collect the following information on each study: years during which the surgery was performed, authors, country, study design, mean age and variance of study participants, type of surgery, gender distribution, complications, co-morbidities, pre-/post-surgery BMI with variance and number of participants, length of follow-up and loss to follow-up. Two authors independently screened the abstracts and extracted data was verified by a second author (JAB and RKS)."
Reasoning: Describes the method of data extraction, done in duplicate.
[Yes]

P11. Methods / Data items
Quote: "We used a standard data extraction method to collect the following information on each study: years during which the surgery was performed, authors, country, study design, mean age and variance of study participants, type of surgery, gender distribution, complications, co-morbidities, pre-/post-surgery BMI with variance and number of participants, length of follow-up and loss to follow-up."
Reasoning: Lists the data items sought from each study.
[Yes]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant.
Reasoning: No methods for assessing risk of bias in individual studies were specified.
[No]

P13. Methods / Summary measures
Quote: "The summary effect measure of unstandardized change in BMI at the time point closest to 12 months post-surgery was produced using the DerSimonian and Laird random effects method (21). The effect of heterogeneity was quantified using the I2 measure and a test for heterogeneity (22)."
Reasoning: Specifies the main summary measures.
[Yes]

P14. Methods / Synthesis of results
Reasoning: Meta-analysis methods were not described in detail. Measures of consistency were not specified.
[No]

P15. Methods / Risk of bias across studies
Quotes: None relevant.
Reasoning: No methods for assessing risk of bias across studies were specified.
[No]

P16. Methods / Additional analyses
Quote: "We also conducted a number of sensitivity analyses to examine whether change in BMI was effected by (i) the refinement of surgical techniques as publication date increased; (ii) gender and (iii) greater pre-surgery BMI. Funnel plots and Egger's test were used to evaluate publication bias and small study effects."
Reasoning: Describes the additional sensitivity analyses performed.
[Yes]

P17. Results / Study selection
Quote: "A total of 2303 unique citations were returned by the search strategy (Fig. 1). Of these, 2185 were excluded based on abstract review. Two additional papers were included from references (n = 2)"
Reasoning: Provides a flow diagram with the numbers of studies screened, assessed for eligibility, and included.
[Yes]

P18. Results / Study characteristics
Quote: "In total, 637 patients from 23 studies were included in the meta-analysis. There were significant decreases in BMI at 1 year (average weighted mean BMI difference: −13.5 kg m−2; 95% confidence interval [CI] −14.1 to −11.9). Complications were inconsistently reported."
Reasoning: Presents some aggregate characteristics of included studies but not for each individual study.
[No]

P19. Results / Risk of bias within studies
Reasoning: Risk of bias of individual studies was not assessed (see P12).
[NA]

P20. Results / Results of individual studies
Quote: Figure 2 presents a forest plot with BMI change results for each individual study.
Reasoning: Provides the individual study results with a forest plot.
[Yes]

P21. Results / Synthesis of results
Quote: "A total of 637 patients from 23 studies were included in the meta-analysis. There were significant decreases in BMI at 1 year (average weighted mean BMI difference: −13.5 kg m−2; 95% confidence interval [CI] −14.1 to −11.9)."
Reasoning: Presents the meta-analysis results with confidence intervals.
[Yes]

P22. Results / Risk of bias across studies
Reasoning: Risk of bias across studies was not assessed (see P15).
[NA]

P23. Results / Additional analysis
Quote: "We also conducted a number of sensitivity analyses to examine whether change in BMI was effected by (i) the refinement of surgical techniques as publication date increased; (ii) gender and (iii) greater pre-surgery BMI. Funnel plots and Egger's test were used to evaluate publication bias and small study effects. Potential risks to the robustness of the estimates found during these tests are reported in the results."
Reasoning: Reports the results of the additional sensitivity analyses.
[Yes]

P24. Discussion / Summary of evidence
Quote: "Bariatric surgery in obese children and adolescents is associated with a significant reduction in BMI after 12 months (average weighted mean BMI difference: −13.5 kg m−2; 95% CI −15.1, −11.9). RYGB was associated with the largest reduction in BMI, followed by SG and then AGB."
Reasoning: Summarizes the main findings including the strength of evidence for the main outcome.
[Yes]

P25. Discussion / Limitations
Quote: "There was some evidence to suggest that bariatric surgery is related to co-morbidity resolution, sleep apnoea, type 2 diabetes and dyslipidaemia, particularly with RYGB surgery. All studies assessing HRQoL showed significant improvements from baseline to post-surgery follow-up."
Reasoning: Discusses some limitations at the review level, such as inconsistent reporting.
[Yes]

P26. Discussion / Conclusions
Quote: "As bariatric surgery seems to be associated with a risk of complications and has the potential to impact on future patterns for a lifetime, a balance must be made between the potential benefits and harms at an individual case level. Surgery access is largely mediated through multidisciplinary teams (e.g. paediatricians, psychologists and dieticians) (42,43), and when applied in this context, bariatric surgery appears to be a viable choice to achieve weight loss in obese adolescents for whom all other interventions have failed. In the absence of higher levels of evidence, results from this systematic review appear to suggest that the potential benefits of surgery for weight loss outweigh the risks. Current guidelines suggest that paediatric-adolescent bariatric care should be handled within the controlled and restricted setting of a multidisciplinary team. However, long-term, prospectively designed studies, with clear inclusion and reporting of effects, side effects, complications and co-morbidity resolution, alongside measures of HRQoL, are needed to more firmly establish the harms and benefits of bariatric surgery in children and adolescents."
Reasoning: Provides a general interpretation of the results in the context of other evidence and implications for future research.
[Yes]

P27. Funding
Quote: "No conflict of interest was declared."
Reasoning: Sources of funding for the systematic review were not described.
[No]

72. Borruto 2010: Laparoscopic vs open varicocelectomy in children and adolescents: review of the recent literature and meta-analysis

LLM response

11 quote(s) from publication full text (mean similarity 99.8%)

A1
"A literature search was performed, using Medline and Pubmed database, on all articles published during the last 10 years (2000-2009), reporting on varicocele treatments."
The authors specified the databases and date range used for the literature search.
[Yes]

A2
No relevant quotes found.
The authors did not mention using at least two independent data extractors or a consensus procedure.
[No]

A3
"Searches were also performed using the following key limits: last 10 years, adolescent, randomized controlled trials, meta-analysis, and multicenter retrospective and prospective studies."
The authors searched Medline and PubMed and used keyword limits, but did not supplement with other sources like reference lists, experts, etc.
[No]

A4
"(1) studies that were not relevant, in which outcome of interest were not reported or were impossible to calculate from the results; and
(2) studies not concerning an adolescent population."
The authors specified inclusion/exclusion criteria related to outcomes and population age, but did not mention publication status or language.
[No]

A5
No relevant quotes found.
The authors did not provide a list of included and excluded studies.
[No]

A6
"The results of continuous variables were reported as mean ± SD, and the statistical difference was calculated using the Student's t test."
The authors reported some summary statistics for the included studies, but did not provide the full range of characteristics in aggregate form.
[No]

A7
"The results were investigated in recurrence and hydrocele formation."
The authors assessed included studies based on recurrence and hydrocele outcomes, but did not specify the tool used or report the quality assessment for each individual study.
[No]

A8
Not applicable, as the authors did not assess the scientific quality of included studies (A7).
[NA]

A9
"Meta-analysis is a useful statistical tool that can be used to compare and integrate different studies in both a qualitative and quantitative way, considering variations in characteristics that can influence the overall estimate of the outcome of interest."
The authors used meta-analysis appropriately to combine study findings.
[Yes]

A10
No relevant quotes found.
The authors did not report assessing the likelihood of publication bias.
[No]

A11
No relevant quotes found.
The authors did not report the sources of support/funding for the systematic review and included studies.
[No]

P1
"Laparoscopic vs open varicocelectomy in children and adolescents: review of the recent literature and meta-analysis"
The title identifies the article as a review and meta-analysis.
[Yes]

P2
The abstract is structured with labeled sections for Purpose, Methods, Results, and Conclusions.
[Yes]

P3
"Varicocele is generally considered the most common correctable cause of male infertility [1,2]. It is indicated as a factor in about one third of infertile males, being associated with testicular atrophy and abnormal seminal factors [3]."
The introduction describes the rationale for the review in the context of what is known about varicocele and male infertility.
[Yes]

P4
"The aim of this study was to identify clinical evidence about the reliability of this technique in the recent literature."
The introduction states the review aim, but does not fully specify the PICOS components.
[No]

P5
No relevant quotes found.
The authors did not mention the existence of or access to a review protocol.
[No]

P6
"(1) studies that were not relevant, in which outcome of interest were not reported or were impossible to calculate from the results; and
(2) studies not concerning an adolescent population."
The authors specified some eligibility criteria related to outcomes and population, but did not fully report the PICOS and rationale.
[No]

P7
"A literature search was performed, using Medline and Pubmed database, on all articles published during the last 10 years (2000-2009), reporting on varicocele treatments."
The authors reported searching Medline and PubMed over a 10 year period, but did not mention other information sources.
[No]

P8
No relevant quotes found.
The authors did not present the full electronic search strategy for any database.
[No]

P9
No relevant quotes found.
The authors did not describe the process for selecting studies.
[No]

P10
No relevant quotes found.
The authors did not describe the method of data extraction.
[No]

P11
No relevant quotes found.
The authors did not provide a list of variables for which data were sought.
[No]

P12
No relevant quotes found.
The authors did not describe methods for assessing risk of bias in individual studies.
[No]

P13
"Meta-analysis is a useful statistical tool that can be used to compare and integrate different studies in both a qualitative and quantitative way, considering variations in characteristics that can influence the overall estimate of the outcome of interest."
The authors mentioned using meta-analysis to compare studies, but did not explicitly state the principal summary measures.
[No]

P14
Not applicable, as this review did not conduct a meta-analysis.
[NA]

P15
Not applicable, as this review did not conduct a meta-analysis.
[NA]

P16
Not applicable, as this review did not conduct a meta-analysis.
[NA]

P17
No relevant quotes found.
The authors did not provide a flow diagram or report the number of studies screened, assessed for eligibility, included, and excluded with reasons.
[No]

P18
No relevant quotes found.
The authors did not present the characteristics and citations of each included study.
[No]

P19
No relevant quotes found.
The authors did not present data on the risk of bias for each included study.
[No]

P20
The authors presented forest plots with odds ratios and 95% confidence intervals for each included study for several outcomes.
[Yes]

P21
Not applicable, as this review did not conduct a meta-analysis.
[NA]

P22
Not applicable, as this review did not conduct a meta-analysis.
[NA]

P23
Not applicable, as this review did not conduct a meta-analysis.
[NA]

P24
"Varicocele has an adverse effect on the histologic, endocrine, and biochemical testis function [11]. To date, there is controversy over the management of varicocele in children and adolescents. The variety of treatment options indicates that the ideal technique to manage this pathologic condition is not yet been determined."
The discussion summarized the main findings and their relevance to key groups.
[Yes]

P25
No relevant quotes found.
The authors did not discuss the limitations of the review at the study, outcome, and review levels.
[No]

P26
"Varicocele has an adverse effect on the histologic, endocrine, and biochemical testis function [11]. To date, there is controversy over the management of varicocele in children and adolescents. The variety of treatment options indicates that the ideal technique to manage this pathologic condition is not yet been determined."
The authors provided a general interpretation of the results in the context of other evidence and the need for determining the ideal treatment technique.
[Yes]

P27
No relevant quotes found.
The authors did not describe sources of funding or other support for the systematic review.
[No]

73. Castagnetti 2010: Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review

LLM response

13 quote(s) from publication full text (mean similarity 99.9%)

A1
Quote: "We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature."
Reasoning: The research question and inclusion criteria are clearly stated.
[Yes]

A2
Quotes: No relevant quotes identified.
Reasoning: The authors do not mention whether study selection and data extraction were performed in duplicate.
[No]

A3
Quotes: "We reviewed studies published between 1990 and December 2009, searching for "hypospadias" in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
Reasoning: At least 2 electronic databases were searched, but no supplementary sources are mentioned.
[No]

A4
Quotes: No relevant quotes identified.
Reasoning: The inclusion of grey literature is not mentioned.
[No]

A5
Quotes: No relevant quotes identified.
Reasoning: A list of included and excluded studies is not provided.
[No]

A6
Quote: "We identified 69 studies for review. These studies were generally of low quality (69.5% surgical series)."
Reasoning: Aggregate characteristics of included studies are not adequately described.
[No]

A7
Quotes: "We identified 69 studies for review. These studies were generally of low quality (69.5% surgical series)."
Reasoning: The authors mention study quality but do not describe the methods used to assess it.
[No]

A8
Quotes: No relevant quotes identified.
Reasoning: Scientific quality is not considered when formulating conclusions, as it was not adequately assessed.
[NA]

A9
Quotes: No relevant quotes identified.
Reasoning: This systematic review does not include a meta-analysis.
[NA]

A10
Quotes: No relevant quotes identified.
Reasoning: Publication bias is not assessed.
[NA]

A11
Quotes: No relevant quotes identified.
Reasoning: Sources of support are not reported for the systematic review or included studies.
[No]

P1
Quote: "Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2
Quote: The abstract is structured with labeled sections for Purpose, Materials and Methods, Results, and Conclusions.
Reasoning: A structured abstract is provided.
[Yes]

P3
Quote: "The ideal surgical management of primary severe hypospadias (proximal hypospadias with severe ventral curvature) remains controversial."
Reasoning: The rationale for the review is described in the context of current knowledge.
[Yes]

P4
Quote: "We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature."
Reasoning: The research question specifies the population, intervention and study design, but not comparisons or outcomes.
[No]

P5
Quotes: No relevant quotes identified.
Reasoning: The existence of a review protocol is not mentioned.
[No]

P6
Quote: "We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature."
Reasoning: The inclusion criteria for study characteristics and report characteristics are partially described.
[No]

P7
Quote: "We reviewed studies published between 1990 and December 2009, searching for "hypospadias" in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
Reasoning: Electronic databases are listed as information sources but the date last searched is not provided.
[No]

P8
Quotes: No relevant quotes identified.
Reasoning: The full search strategy is not presented.
[No]

P9
Quotes: No relevant quotes identified.
Reasoning: The study selection process is not described.
[No]

P10
Quotes: No relevant quotes identified.
Reasoning: The data collection process is not described.
[No]

P11
Quotes: No relevant quotes identified.
Reasoning: Data items are not defined.
[No]

P12
Quotes: No relevant quotes identified.
Reasoning: Methods for assessing risk of bias of individual studies are not described.
[No]

P13
Quotes: No relevant quotes identified.
Reasoning: The principal summary measures are not stated.
[No]

P14
Quotes: No relevant quotes identified.
Reasoning: This systematic review does not include a meta-analysis.
[NA]

P15
Quotes: No relevant quotes identified.
Reasoning: This systematic review does not include a meta-analysis.
[NA]

P16
Quotes: No relevant quotes identified.
Reasoning: This systematic review does not include a meta-analysis.
[NA]

P17
Quote: "The search yielded 69 pertinent studies."
Reasoning: The number of studies included in the review is provided, but a flow diagram is not included and the numbers screened and assessed for eligibility are not given.
[No]

P18
Quotes: No relevant quotes identified.
Reasoning: Characteristics of individual studies are not presented.
[No]

P19
Quotes: No relevant quotes identified.
Reasoning: Risk of bias assessments for individual studies are not reported.
[No]

P20
Quotes: No relevant quotes identified.
Reasoning: Results for individual studies are not provided.
[No]

P21
Quotes: No relevant quotes identified.
Reasoning: This systematic review does not include a meta-analysis.
[NA]

P22
Quotes: No relevant quotes identified.
Reasoning: This systematic review does not include a meta-analysis.
[NA]

P23
Quotes: No relevant quotes identified.
Reasoning: This systematic review does not include a meta-analysis.
[NA]

P24
Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias. We even lack a clear-cut definition of severe hypospadias and associated curvature."
Reasoning: The main findings are summarized.
[Yes]

P25
Quote: "As we continually try to improve the outcomes for our patients with hypospadias, we need to have a better classification system. As the authors indicate, "Future research should strive to stratify included cases accurately based on meatal position and curvature preoperatively, following skin degloving and following each step required for straightening.""
Reasoning: Limitations at the review level are discussed.
[Yes]

P26
Quote: "Clearly it is our obligation to work together as pediatric urology community so that better outcomes studies can be performed for our patients, ultimately improving their well-being."
Reasoning: A general interpretation is provided in the context of other evidence and implications for future research are discussed.
[Yes]

P27
Quotes: No relevant quotes identified.
Reasoning: Sources of funding for the systematic review are not described.
[No]

74. Castagnetti 2016: Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis

LLM response

26 quote(s) from publication full text (mean similarity 99.9%)

A1 - Protocol/a priori design:
"We performed a systematic review of the literature on preputial reconstruction (PR) during hypospadias repair to determine the cumulative risk of preputial skin complications and the influence of PR on urethroplasty complications, namely, fistula formation and overall reoperation rate of the repair."
The objectives and inclusion criteria were established before conducting the review.
[Yes]

A2 - Duplicate study selection and data extraction:
No information provided on whether at least two independent reviewers selected studies and extracted data.
[No]

A3 - Comprehensive literature search:
"A systematic search of the literature published after 06/1995 was performed in 06/2015 using the keyword "hypospadias." Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected. A meta-analysis of studies comparing PR vs. circumcision was performed for the outcomes "hypospadias fistula formation" and "reoperation rate.""
At least 2 databases (MEDLINE/PubMed, Scopus, and The Cochrane library) were searched over a 20-year period using the keyword "hypospadias".
[Yes]

A4 - Grey literature as inclusion criterion:
No information provided on whether grey literature was included or excluded based on publication type.
[No]

A5 - List of included and excluded studies:
"Twenty studies were identified. Nineteen reported the outcome of PR in 2115 patients."
A list of included studies is provided in Table 1, but no list of excluded studies is provided.
[No]

A6 - Characteristics of included studies:
"Characteristics of included studies are detailed in Table 1. The vast majority (13, 65%) were surgical series (LOE 4), three (15%) were retrospective case–control studies (LOE 4), two (10%) were longitudinal cohort studies (LOE 3), and the remaining two (10%) were RCTs (LOE 2)."
Aggregated data on study characteristics is provided.
[Yes]

A7 - Scientific quality assessment of included studies:
"Also the latter, however, were fraught with significant methodological bias such as lack of power analysis, unclear randomization method, and/or lack of blinding."
The scientific quality of included studies was assessed and documented.
[Yes]

A8 - Scientific quality used in formulating conclusions:
"Preputial reconstruction is an option during hypospadias repair, but some authors suggest isolated PR to be the procedure of choice in minor variants of hypospadias in order to conceal the malformation while avoiding the risks associated with urethroplasty."
The results of the quality assessment were considered in the analysis and conclusions.
[Yes]

A9 - Methods to combine findings:
"A meta-analysis (Figure 2) showed no increased risk of urethral fistula formation in patients where the prepuce was preserved, OR (Mantel–Haenszel, fixed effect, 95% CI), 1.25 (0.80–1.97). This was even more evident after exclusion of retrospective studies, i.e., considering only studies with higher LOE (Figure 2)."
Appropriate methods were used to combine the findings of studies, including assessment of heterogeneity and use of fixed-effects models.
[Yes]

A10 - Publication bias assessment:
"Funnel Plot did not show evidence of significant bias among studies (Figure 3)."
Publication bias was assessed using a funnel plot.
[Yes]

A11 - Conflict of interest stated:
No information provided on conflict of interest for the systematic review or included studies.
[No]

P1 - Title:
"Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis"
The article is identified as a systematic review and meta-analysis in the title.
[Yes]

P2 - Structured abstract:
The article has a structured abstract with labeled sections for Introduction, Materials and Methods, Results, and Conclusion.
[Yes]

P3 - Introduction rationale:
"Preputial asymmetry is one of the components of hypospadias. The prepuce stands like a hood over the glans penis, open ventrally, and redundant dorsally. Preputial reconstruction (PR) is an option during hypospadias repair, but many surgeons favor circumcision for the concern that PR might increase the complication rate of hypospadias repair (1)."
The rationale for the review is described in the context of what is already known.
[Yes]

P4 - Introduction objectives:
"We performed a systematic review of the literature on preputial reconstruction (PR) during hypospadias repair to determine the cumulative risk of preputial skin complications and the influence of PR on urethroplasty complications, namely, fistula formation and overall reoperation rate of the repair."
The research question is stated with reference to participants, interventions, and outcomes.
[Yes]

P5 - Methods protocol and registration:
No information provided on a review protocol or registration.
[No]

P6 - Methods eligibility criteria:
"Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected."
Study characteristics used as eligibility criteria are specified.
[Yes]

P7 - Methods information sources:
"A systematic search of the literature published after 06/1995 was performed in 06/2015 using the keyword "hypospadias." Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected."
Information sources and dates searched are described.
[Yes]

P8 - Methods search:
The full search strategy is not presented such that it could be repeated.
[No]

P9 - Methods study selection:
"One-thousand two-hundred thirty records were retrieved by searching MEDLINE/PubMed, 2461 Web of Sciences, and 1 the Cochrane library. Three doctors reviewed separately the abstracts. Papers relevant to the topic of the review were selected by consensus. A second review was performed of these papers and their reference lists."
The process for selecting studies is described.
[Yes]

P10 - Methods data collection process:
No information provided on the method of data extraction.
[No]

P11 - Methods data items:
No information provided on the data items sought.
[No]

P12 - Methods risk of bias in individual studies:
"Also the latter, however, were fraught with significant methodological bias such as lack of power analysis, unclear randomization method, and/or lack of blinding."
Methods for assessing risk of bias in individual studies are described.
[Yes]

P13 - Methods summary measures:
"A meta-analysis (Figure 2) showed no increased risk of urethral fistula formation in patients where the prepuce was preserved, OR (Mantel–Haenszel, fixed effect, 95% CI), 1.25 (0.80–1.97)."
The principal summary measures (odds ratios) are stated.
[Yes]

P14 - Methods synthesis of results:
"A meta-analysis (Figure 2) showed no increased risk of urethral fistula formation in patients where the prepuce was preserved, OR (Mantel–Haenszel, fixed effect, 95% CI), 1.25 (0.80–1.97). This was even more evident after exclusion of retrospective studies, i.e., considering only studies with higher LOE (Figure 2)."
The methods for combining results and assessing consistency are described.
[Yes]

P15 - Methods risk of bias across studies:
"Funnel Plot did not show evidence of significant bias among studies (Figure 3)."
Risk of bias that may affect the cumulative evidence was assessed.
[Yes]

P16 - Methods additional analyses:
"Only two studies including one prospective longitudinal cohort study and one retrospective case–control study compared overall reoperation rate in patients undergoing distal hypospadias repair associated with PR vs. circumcision. Again, a meta-analysis of these (Figure 4) showed no increased risk of reoperation in patients undergoing PR."
Additional analyses (subgroup analyses) were described.
[Yes]

P17 - Results study selection:
"One-thousand two-hundred thirty records were retrieved by searching MEDLINE/PubMed, 2461 Web of Sciences, and 1 the Cochrane library. Three doctors reviewed separately the abstracts. Papers relevant to the topic of the review were selected by consensus. A second review was performed of these papers and their reference lists. In the review, we included only studies reporting data on complications of PR (dehiscence of reconstructed prepuce and phimosis), on urethroplasty complications (fistula formation), and on reoperation rates in patients undergoing hypospadias repair with preservation of the prepuce. Studies including only patients undergoing hypospadias repair associated with circumcision, reporting PR in adults or for conditions other than hypospadias, studies with incomplete data (no separate results reported in patients undergoing PR), duplicate publications, population-based studies, single-case reports, reviews, editorials, letter to the editor, meeting abstracts, book chapters, and experimental studies were excluded."
A flow diagram is provided showing the number of studies screened, assessed for eligibility, and included.
[Yes]

P18 - Results study characteristics:
Characteristics of included studies are provided in Table 1.
[Yes]

P19 - Results risk of bias within studies:
"Also the latter, however, were fraught with significant methodological bias such as lack of power analysis, unclear randomization method, and/or lack of blinding."
Results of the risk of bias assessment for individual studies are presented.
[Yes]

P20 - Results of individual studies:
Data for individual studies are provided in Table 2 and Figures 2-4.
[Yes]

P21 - Results synthesis of results:
"A meta-analysis (Figure 2) showed no increased risk of urethral fistula formation in patients where the prepuce was preserved, OR (Mantel–Haenszel, fixed effect, 95% CI), 1.25 (0.80–1.97). This was even more evident after exclusion of retrospective studies, i.e., considering only studies with higher LOE (Figure 2)."
Results of the meta-analysis are presented with confidence intervals and measures of consistency.
[Yes]

P22 - Results risk of bias across studies:
"Funnel Plot did not show evidence of significant bias among studies (Figure 3)."
Results of the assessment of risk of bias across studies are presented.
[Yes]

P23 - Results additional analyses:
"Only two studies including one prospective longitudinal cohort study and one retrospective case–control study compared overall reoperation rate in patients undergoing distal hypospadias repair associated with PR vs. circumcision. Again, a meta-analysis of these (Figure 4) showed no increased risk of reoperation in patients undergoing PR."
Results of the additional analyses are provided.
[Yes]

P24 - Discussion summary of evidence:
"This systematic review shows that according to available evidence PR carries an 8% risk of specific preputial complications, whereas it does not seem to increase the risk of urethroplasty complications and the overall reoperation rate of hypospadias repairs."
The main findings are summarized.
[Yes]

P25 - Discussion limitations:
"Preputial reconstruction is an option during hypospadias repair, but some authors suggest isolated PR to be the procedure of choice in minor variants of hypospadias in order to conceal the malformation while avoiding the risks associated with urethroplasty. The diverse regions of origin of studies included in present review suggests that the procedure is requested all-over the world and Klijn et al. underlined that the request is growing also in centers where circumcision is offered as first option."
Limitations at the study and review level are discussed.
[Yes]

P26 - Discussion conclusions:
"Preputial reconstruction is an option particularly in patients with distal hypospadias without associated penile curvature. It carries an 8% risk of specific complications, the most common being dehiscence of reconstructed prepuce, whereas secondary phimosis needing circumcision seems to be exceptional although we lack long-term follow-up data on these patients. Overall, PR does not seem to increase the risk of urethroplasty complications and the overall reoperation rate of hypospadias repair."
A general interpretation of the results is provided.
[Yes]

P27 - Funding:
No information provided on sources of funding for the systematic review.
[No]

75. Chan 2014 (Pediatr Surg Int): Ideal timing of orchiopexy: a systematic review

LLM response

32 quote(s) from publication full text (mean similarity 99.6%)

4 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1
Quote: "The aim of this study was to determine, based on a systematic review, the most favorable age at which orchiopexy should be performed."
Reasoning: The research question and inclusion criteria were established a priori.
[Yes]

A2
Quotes: "Two researchers quality assessed each study; comparing the scores for each item on each tool to reach a consensus. If no consensus could be reached, they consulted a third researcher."
"One researcher extracted data from each of the included studies, and a second researcher checked the data for accuracy and completeness."
Reasoning: Study selection and data extraction were done in duplicate with a consensus procedure.
[Yes]

A3
Quotes: "We conducted electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 onwards), Embase (1980 onwards), and CINAHL (1982 onwards) to find relevant articles."
"We also excluded any editorials and case reviews. We hand-searched the reference lists of relevant articles for additional studies."
Reasoning: At least 2 electronic databases were searched and supplemented by hand searching reference lists.
[Yes]

A4
Quote: "Due to the heterogeneity of the data, we could not conduct a meta-analysis."
Reasoning: The authors did not explicitly state that they searched for reports regardless of publication type.
[No]

A5
Quote: "After screening, we quality assessed the 32 remaining studies that met our criteria (Fig. 1). Publication dates ranged from 1974 to 2011."
Reasoning: A flow diagram of included studies was provided, but a list of excluded studies was not.
[No]

A6
Quote: "From there, we were able to reach a conclusion regarding the ideal timing of orchiopexy in cryptorchid children based on the highest quality research available."
Reasoning: Characteristics of the included studies were not provided in an aggregated form.
[No]

A7
Quotes: "We used the Jadad et al. [21] tool to assess the quality of all relevant RCTs. This scale contains seven items, two of which are reverse-scored. The maximum score is 5, with higher scores indicating greater methodological quality."
"We used the MINORS criteria [22] to assess the quality of all relevant non-randomized studies. This tool contains 12 items, each of which can be scored from 0 to 2, for a maximum possible score of 24 (comparison studies) or 16 (non-comparison studies). Higher scores are indicative of greater methodological quality."
Reasoning: The scientific quality of included studies was assessed using the Jadad and MINORS tools.
[Yes]

A8
Quote: "Previous research has shown that testicular location may affect both fertility and malignancy; compared with unilateral undescended testes, intra-abdominal testes were associated with decreased fertility potential [5, 38, 59] and increased malignancy risk [60, 61]."
Reasoning: The results of the methodological quality assessment were considered when formulating conclusions.
[Yes]

A9
Quote: "Due to the heterogeneity of the data, we could not conduct a meta-analysis."
Reasoning: The authors stated they could not combine the studies in a meta-analysis due to heterogeneity.
[Yes]

A10
Quotes: "We did not find any systematic reviews or meta-analyses reporting on the impact of age at orchiopexy on fertility (Table 1)."
"Some studies also reported on semen analysis in adulthood (i.e., sperm count, sperm concentration) [11, 25, 29–32, 35, 37, 38, 40, 41]. The overall consensus was that earlier orchiopexy had better outcomes; specifically, the highest quality study [11] showed that sperm count and highly motile spermatozoa were significantly increased when orchiopexy was performed at <1 year compared to 1–2 years of age."
Reasoning: Publication bias was not assessed, likely because this was a systematic review without a meta-analysis.
[NA]

A11
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: Sources of funding were not reported for the systematic review or the included studies.
[No]

P1
Quote: "Ideal timing of orchiopexy: a systematic review"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2
Quote: "The ideal management of cryptorchidism is a highly debated topic within the field of pediatric surgery. The optimal timing of orchiopexy is particularly unclear, as existing literature reports mixed recommendations. The aim of this study was to determine, based on a systematic review, the most favorable age at which orchiopexy should be performed. We conducted a systematic search of MEDLINE, Embase, CINAHL, and the Cochrane Library to find relevant articles. Two researchers quality assessed each study using the following tools: AMSTAR (systematic reviews), Jadad (RCTs), and MINORS (non-RCTs). We developed a conclusion based on the highest quality studies. We found one relevant systematic review, one RCT, and 30 non-RCTs. Fertility potential was greatest when orchiopexy was performed before 1 year of age. Additionally, orchiopexy before 10–11 years may protect against the increased risk of testicular cancer associated with cryptorchidism. Orchiopexy should not be performed before 6 months of age, as testes may descend spontaneously during the first few months of life. The highest quality evidence recommends orchiopexy between 6 and 12 months of age. Surgery during this timeframe may optimize fertility potential and protect against testicular malignancy in children with cryptorchidism."
Reasoning: The abstract provides a structured summary including background, objectives, data sources, study eligibility criteria, study appraisal and synthesis methods, and conclusions.
[Yes]

P3
Quote: "Cryptorchidism, the failure of one or both testes to descend into the scrotum prenatally, occurs in 2.4–5 % of newborns [1, 2]. Many of these testes will descend spontaneously shortly after birth, but approximately 23 % will remain undescended unless surgically corrected [3]."
Reasoning: The introduction describes the rationale for the review in the context of what is already known about cryptorchidism.
[Yes]

P4
Quote: "The aim of this study was to determine, based on a systematic review, the most favorable age at which orchiopexy should be performed."
Reasoning: The introduction provides an explicit statement of the question being addressed, referencing the population (cryptorchid boys) and intervention (orchiopexy).
[Yes]

P5
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: The existence of a review protocol is not mentioned.
[No]

P6
Quotes: "We identified experts with proficiency in this area, based on the number of previous publications."
"We included all studies that examined the effect of age at orchiopexy on fertility or malignancy, even if these outcomes were not the primary focus. If we deemed a study relevant based on the title and abstract, we obtained the full text article to further screen for relevance."
Reasoning: The methods section specifies the study characteristics (population, intervention, comparators, outcomes) and report characteristics (no date or language limits mentioned) used as eligibility criteria.
[Yes]

P7
Quote: "We conducted electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 onwards), Embase (1980 onwards), and CINAHL (1982 onwards) to find relevant articles."
Reasoning: The information sources searched are described but the date last searched is not provided.
[No]

P8
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: The full search strategy is not presented for any of the databases searched.
[No]

P9
Quotes: "After screening, we quality assessed the 32 remaining studies that met our criteria (Fig. 1)."
"Two researchers independently performed each level of screening, comparing the selected studies to reach a consensus. If a consensus could not be reached, they consulted a third researcher."
Reasoning: The study selection process is described, including screening by two independent researchers with a consensus procedure.
[Yes]

P10
Quote: "One researcher extracted data from each of the included studies, and a second researcher checked the data for accuracy and completeness."
Reasoning: The data extraction process is described, involving extraction by one researcher and verification by a second researcher.
[Yes]

P11
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: The data items sought are not explicitly listed or defined.
[No]

P12
Quotes: "We used the Jadad et al. [21] tool to assess the quality of all relevant RCTs. This scale contains seven items, two of which are reverse-scored. The maximum score is 5, with higher scores indicating greater methodological quality."
"We used the MINORS criteria [22] to assess the quality of all relevant non-randomized studies. This tool contains 12 items, each of which can be scored from 0 to 2, for a maximum possible score of 24 (comparison studies) or 16 (non-comparison studies). Higher scores are indicative of greater methodological quality."
Reasoning: The Jadad and MINORS tools were used to assess risk of bias in individual RCTs and non-randomized studies, respectively.
[Yes]

P13
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: The principal summary measures are not stated.
[No]

P14
Quote: "Due to the heterogeneity of the data, we could not conduct a meta-analysis."
Reasoning: A meta-analysis was not performed, so the methods of data handling and combining results do not apply.
[NA]

P15
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: Assessment of risk of bias that may affect the cumulative evidence (e.g. publication bias, selective reporting) is not mentioned.
[No]

P16
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: Additional analyses are not mentioned.
[No]

P17
Quote: "After screening, we quality assessed the 32 remaining studies that met our criteria (Fig. 1). Publication dates ranged from 1974 to 2011."
Reasoning: A flow diagram is provided showing the number of studies screened, assessed for eligibility, and included, with reasons for exclusions at each stage.
[Yes]

P18
Quote: "Table 1 Studies assessing impact of age at orchiopexy on fertility"
Reasoning: A table is provided presenting the characteristics of each included study, including study period, design, population, age at surgery, and outcomes assessed.
[Yes]

P19
Quotes: "We used the Jadad et al. [21] tool to assess the quality of all relevant RCTs. This scale contains seven items, two of which are reverse-scored. The maximum score is 5, with higher scores indicating greater methodological quality."
"We used the MINORS criteria [22] to assess the quality of all relevant non-randomized studies. This tool contains 12 items, each of which can be scored from 0 to 2, for a maximum possible score of 24 (comparison studies) or 16 (non-comparison studies). Higher scores are indicative of greater methodological quality."
Reasoning: The results of the risk of bias assessments using the Jadad and MINORS tools are presented for each included study.
[Yes]

P20
Quote: "Table 1 Studies assessing impact of age at orchiopexy on fertility"
Reasoning: The results table provides the outcome data for each study, but does not include effect estimates and confidence intervals.
[No]

P21
Quote: "Due to the heterogeneity of the data, we could not conduct a meta-analysis."
Reasoning: A meta-analysis was not performed, so results of each meta-analysis do not apply.
[NA]

P22
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: Assessment of risk of bias across studies is not mentioned.
[No]

P23
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: Additional analyses were not mentioned.
[No]

P24
Quotes: "The ideal timing of orchiopexy for cryptorchidism has long been debated. Although the recommended age for this surgery has decreased over the years, the literature is still unclear about the exact age at which orchiopexy should be performed to optimize patient outcomes."
"Previous research has focused on two main outcomes after cryptorchidism: fertility and testicular malignancy. Regarding fertility, several measures have been examined, including testicular growth/ size, testicular histology, semen analysis, and paternity rate. Most of these measures serve as surrogates of fertility, as paternity rate is the only direct measure of the only direct measures of male fertility."
Reasoning: The discussion summarizes the main findings regarding the ideal timing of orchiopexy for optimizing fertility and reducing testicular cancer risk in cryptorchid boys.
[Yes]

P25
Quote: "For this systematic review, we ran a comprehensive search of four major databases and did not set a date limitation; thus, the studies we found should be representative of the available literature. However, we did restrict our search to English language studies only, potentially excluding good quality studies in other languages. Finally, as with all systematic reviews, there is risk of publication bias; many studies without significant results may have gone unpublished, and as such we would not have been able to incorporate them into our review."
Reasoning: Limitations at the study level (English-only studies) and review level (potential publication bias) are discussed.
[Yes]

P26
Quote: "In this systematic review, we assessed the quality of all studies pertaining to this topic and developed recommendations based on the highest quality evidence. Previous research has focused on two main outcomes after cryptorchidism: fertility and testicular malignancy."
Reasoning: The discussion provides a general interpretation of the results in the context of the evidence on fertility and testicular cancer risk after cryptorchidism. Implications for future research are not explicitly stated.
[No]

P27
Quote: "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a "yes," must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: Sources of funding for the systematic review are not reported.
[No]

76. Chan 2014 (J Pediatr Surg): Minimally invasive versus open repair of Bochdalek hernia: a meta-analysis

LLM response

25 quote(s) from publication full text (mean similarity 93.3%)

A1. Was an 'a priori' design provided?
Quote: "Our objective was to compare the outcomes of these procedures in a systematic review and meta-analysis."
Reasoning: The objective is stated, but there is no mention of a protocol, ethics approval, or pre-registered research objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quote: "Two researchers independently assessed each study and compared their scores for each item to reach a consensus. If an agreement could not be reached, they consulted a third researcher."
Reasoning: Two researchers independently performed study selection and compared their results to reach consensus, with a third researcher consulted if needed.
[Yes]

A3. Was a comprehensive literature search performed?
Quotes: "To identify all studies comparing MIS with open surgery for CDH repair, we conducted an electronic search of MEDLINE (1966 onwards), Embase (1980 onwards), and the Cochrane Central Register of Controlled Trials (CENTRAL). We used the keywords "diaphragmatic hernia", "thoracoscopy", "laparoscopy", "minimally invasive surgery", and "open". We excluded any studies that did not pertain to humans and children. We also excluded editorials, case reviews, and any studies that did not compare outcomes of MIS with open surgery for Bochdalek-type hernia."
Reasoning: At least 2 electronic databases were searched with keywords provided. Additional sources like current contents, textbooks, or experts were not mentioned.
[No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quote: "We excluded any studies that did not pertain to humans and children. We also excluded editorials, case reviews, and any studies that did not compare outcomes of MIS with open surgery for Bochdalek-type hernia."
Reasoning: Exclusion based on publication type is mentioned, but no explicit statement about including grey literature.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "Our initial search of MEDLINE, Embase and CENTRAL yielded 160 studies (Fig. 1). After applying our exclusion criteria, 9 studies remained. We identified one additional relevant study through hand-searching, thus we included 10 studies in total [8–17]."
Reasoning: A flow diagram of study selection is provided, but no list of excluded studies is given.
[No]

A6. Were the characteristics of the included studies provided?
Quote: "We did not identify any randomized controlled trials (RCTs) as all identified studies were retrospective in nature. Characteristics of studies included in the meta-analysis are detailed in Table 1."
Reasoning: Study characteristics are provided in an aggregated table (Table 1).
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: "Two researchers independently assessed each study for methodological quality using MINORS. The score for each study is reported in Table 1. All studies were retrospective in nature and none employed a blinding technique for data collection."
Reasoning: Study quality was assessed using the MINORS tool by two independent researchers and scores are reported.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quote: "Our pooled analysis revealed that MIS had a significantly longer operative time than open surgery (mean difference 58.71 min [42.03, 69.39] p < 0.001, Fig. 3F). This finding was consistent even when we performed a subgroup analysis with only the studies that reported follow-up time ≥12 months [10–12,14] (OR 3.21 [1.12, 9.18] p = 0.03, Fig. 3E)."
Reasoning: The results take into account the quality of included studies by performing subgroup analyses with higher quality studies.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "We used a fixed-effects model. When heterogeneity was moderate to high (Q test p > 0.10, I2 > 50%), we used a random-effects model [7]. We used weighted mean differences to analyze continuous data and odds ratios to analyze categorical variables."
"Heterogeneity: Chi2 = 6.51, df = 5 (P = 0.26); I2 = 23%"
Reasoning: Appropriate methods were used to combine study findings based on heterogeneity assessment. Heterogeneity statistics are reported for each meta-analysis.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quote: "To address the risk of publication bias, we created a funnel plot for the recurrence outcome (Fig. 2). All of the studies fell within the 95% confidence interval lines, although the plot was slightly asymmetrical, indicating the possibility of publication bias."
Reasoning: Publication bias was assessed using a funnel plot for one of the main outcomes (recurrence).
[Yes]

A11. Was the conflict of interest included?
Quote: Not applicable, as this is a systematic review without a meta-analysis.
Reasoning: Conflict of interest is not mentioned for the systematic review itself or the included studies.
[No]

P1. Title
Quote: "Minimally invasive versus open repair of Bochdalek hernia: a meta-analysis"
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quote: The abstract is structured with labeled sections for Background, Methods, Results, and Conclusions.
Reasoning: A structured abstract with the required sections is provided.
[Yes]

P3. Introduction / Rationale
Quote: "Traditionally, CDH repair was performed using an open approach, most often by laparotomy. In 1995, Silen performed the first MIS repair on an adolescent patient, and since then the minimally invasive technique has undergone significant evolution [3], becoming increasingly employed over the last 10 years."
Reasoning: The rationale for the review is described in the context of what is already known about the topic.
[Yes]

P4. Introduction / Objectives
Quote: "Our objective was to compare the outcomes of these procedures in a systematic review and meta-analysis."
Reasoning: The objective is explicitly stated, but does not mention all PICOS elements.
[No]

P5. Methods / Protocol and registration
Quote: Not mentioned
Reasoning: No mention of a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quote: "We excluded any studies that did not pertain to humans and children. We also excluded editorials, case reviews, and any studies that did not compare outcomes of MIS with open surgery for Bochdalek-type hernia."
Reasoning: Eligibility criteria are specified, but the full PICOS and rationale are not provided.
[No]

P7. Methods / Information sources
Quote: "To identify all studies comparing MIS with open surgery for CDH repair, we conducted an electronic search of MEDLINE (1966 onwards), Embase (1980 onwards), and the Cochrane Central Register of Controlled Trials (CENTRAL)."
Reasoning: Electronic databases searched are described with dates of coverage.
[Yes]

P8. Methods / Search
Quote: "We used the keywords "diaphragmatic hernia", "thoracoscopy", "laparoscopy", "minimally invasive surgery", and "open"."
Reasoning: The full search strategy is not provided, but the keywords used are listed.
[No]

P9. Methods / Study selection
Quote: See Figure 1 flow diagram.
Reasoning: The study selection process is illustrated in a flow diagram.
[Yes]

P10. Methods / Data collection process
Quote: "Two researchers independently assessed each study and compared their scores for each item to reach a consensus. If an agreement could not be reached, they consulted a third researcher."
Reasoning: The data extraction process is described, involving two independent researchers and a consensus procedure.
[Yes]

P11. Methods / Data items
Quote: Not mentioned
Reasoning: The variables for which data were sought are not pre-specified.
[No]

P12. Methods / Risk of bias in individual studies
Quote: "Two researchers independently assessed each study for methodological quality using MINORS. The score for each study is reported in Table 1. All studies were retrospective in nature and none employed a blinding technique for data collection."
Reasoning: The MINORS tool was used to assess risk of bias in the included studies.
[Yes]

P13. Methods / Summary measures
Quote: "Our primary outcome of interest was hernia recurrence after surgery. Secondary outcomes included operative time, total length of stay (LOS), postoperative ventilator time and postoperative mortality."
Reasoning: The main outcome measures are stated.
[Yes]

P14. Methods / Synthesis of results
Quote: Not applicable, as no meta-analysis was performed.
Reasoning: The methods for meta-analysis are not described as no meta-analysis was done.
[NA]

P15. Methods / Risk of bias across studies
Quote: "To address the risk of publication bias, we created a funnel plot for the recurrence outcome (Fig. 2). All of the studies fell within the 95% confidence interval lines, although the plot was slightly asymmetrical, indicating the possibility of publication bias."
Reasoning: Publication bias was assessed using a funnel plot.
[Yes]

P16. Methods / Additional analyses
Quote: Not applicable, as no additional analyses were performed.
Reasoning: No additional analyses such as sensitivity or subgroup analyses are mentioned.
[NA]

P17. Results / Study selection
Quote: See Figure 1 flow diagram.
Reasoning: The study selection process and reasons for exclusions at each stage are shown in a flow diagram.
[Yes]

P18. Results / Study characteristics
Quote: See Table 1.
Reasoning: The characteristics of included studies are provided in Table 1.
[Yes]

P19. Results / Risk of bias within studies
Quote: "Two researchers independently assessed each study for methodological quality using MINORS. The score for each study is reported in Table 1. All studies were retrospective in nature and none employed a blinding technique for data collection."
Reasoning: The risk of bias assessment for each included study is reported.
[Yes]

P20. Results / Results of individual studies
Quote: See Figures 3A-I.
Reasoning: Forest plots showing the results for individual studies are provided for each outcome.
[Yes]

P21. Results / Synthesis of results
Quote: Not applicable, as no meta-analysis was performed.
Reasoning: No meta-analysis results are presented.
[NA]

P22. Results / Risk of bias across studies
Quote: Not applicable, as no assessment of risk of bias across studies was performed.
Reasoning: The results of the publication bias assessment are not reported.
[NA]

P23. Results / Additional analysis
Quote: Not applicable, as no additional analyses were performed.
Reasoning: No additional analyses were mentioned in the methods, so no results are expected.
[NA]

P24. Discussion / Summary of evidence
Quote: "Our analysis revealed that MIS was associated with a higher recurrence rate which is consistent with the findings from Lansdale et al. [3]. Furthermore, they did not perform a separate analysis for patients requiring patch repair. We have conducted a more comprehensive review, in which we include the 3 studies originally reviewed by Lansdale et al., as well as 7 additional studies that have been published in the last 2 years."
Reasoning: The main findings are summarized, including their consistency with previous evidence.
[Yes]

P25. Discussion / Limitations
Quote: "Despite the growing popularity of minimally invasive techniques in pediatric surgery, research comparing MIS versus open repair of CDH is scarce. All existing literature is retrospective in design and is thus limited by weaknesses such as selection bias. RCTs are regarded as the highest quality clinical evidence; however it would be difficult, if not impossible, to conduct such studies in this patient group."
Reasoning: Limitations at the study and review level are discussed.
[Yes]

P26. Discussion / Conclusions
Quote: "Our review was significantly longer for MIS than for open surgery. This is consistent with the findings from Lansdale et al. [3]. Operative time was significantly longer for MIS than open surgery. This may be related to the technical difficulty of the MIS procedure, and while operative time can be reduced with surgeon experience, it is unlikely that MIS will ever be as fast as open surgery."
Reasoning: The conclusions provide a general interpretation of the results in the context of other evidence and implications for future research.
[Yes]

P27. Funding
Quote: Not mentioned
Reasoning: Sources of funding for the systematic review are not reported.
[No]

77. Chang 2015: Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis

LLM response

23 quote(s) from publication full text (mean similarity 98.1%)

A1
Quote: "We used the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement to report our findings."
Reasoning: The authors mention using PRISMA to report their findings, but do not explicitly state that they established the research question and inclusion criteria a priori.
[No]

A2
Quotes: "Hsu and Chang independently searched and reviewed the articles. When discrepancies occurred over the results, discussions with a third author (Yang) were made to reach a consensus."
"The obtained data were analyzed with Cochrane Collaboration Review Manager (RevMan®, version 5.3)."
Reasoning: The authors mention that two authors independently searched and reviewed articles, with a third author resolving discrepancies, and they used Cochrane software for the analysis, suggesting duplicate study selection and data extraction.
[Yes]

A3
Quotes: "We searched PubMed® for comparative studies (from January 1990 to 2014 September) that compared the efficacy and safety of robotic versus open pyeloplasty. Searches were limited to studies published in English. We used the following keywords: robotic, pyeloplasty, ureteropelvic junction obstruction, children, and pediatric."
Reasoning: The authors searched PubMed and provided the search terms, but only searched one database and did not mention supplementing the electronic search.
[No]

A4
Reasoning: The authors do not mention searching for grey literature or unpublished studies.
[No]

A5
Reasoning: The authors provide a flowchart (Fig. 1) showing the number of studies included and excluded at each stage, but do not provide a list of the excluded studies.
[No]

A6
Quote: "Totally, seven retrospective comparative trials [9–15] and three studies [4, 16, 17] using national database were included. The demographic data of the patients in the 10 included trials are shown in Table 1."
Reasoning: The authors provide the characteristics of the included studies in an aggregated form in Table 1.
[Yes]

A7
Quotes: "Two authors of this paper, Hsu and Chang, evaluated the quality of the study."
"We extracted the following information from each study: study population characteristics, study design, inclusion and exclusion criteria, operation method, surgical approach, days of hospital stay, complication rate, follow-up period, and assessment of success rate."
Reasoning: The authors mention assessing study quality and extracting information on study design and methods, but do not provide the results of the quality assessment for each study.
[No]

A8
Reasoning: The authors do not appear to have assessed the scientific quality of the included studies, so this item is not applicable.
[NA]

A9
Quotes: "The meta-analysis was performed using the Review Manager® statistical software (Version 5.3, Cochrane Collaboration, Oxford, England)."
"We analyzed the dichotomous outcomes using risk ratios (RRs) as the summary statistic. Chi-square statistical tests (Q statistics) and the I2 test were used to test the heterogeneity between the trials. Studies without mean values and standard deviation for continuous variables were not included for calculation. The parameters with mean value and 95 % confidence interval were transformed into mean values with standard deviation for calculation of weighted mean difference."
Reasoning: The authors used Review Manager software to perform the meta-analysis, used appropriate summary statistics, and assessed heterogeneity using Chi-square and I2 tests.
[Yes]

A10
Quote: "We analyzed the possible publication bias by generating funnel plots of the trials used for all of the evaluated comparisons of outcomes. No clear bias was apparent."
Reasoning: The authors assessed publication bias using funnel plots.
[Yes]

A11
Reasoning: The authors do not report the sources of funding or conflicts of interest for the included studies.
[No]

P1
Quote: "Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis"
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2
Quotes: The abstract includes structured sections with background, methods, results, and conclusions.
Reasoning: The abstract is structured and includes the required elements.
[Yes]

P3
Quote: "Open dismembered pyeloplasty remained the best standard treating children with ureteropelvic junction obstruction (UPJO) despite the introduction of minimal invasive therapy. The progress of this technique had shifted from standard laparoscopic (LP), mini-laparoscopic, robotic-assisted pyeloplasty (RP), and laparoendoscopic single-site incision (LESS) to robotic LESS pyeloplasty [1]. The technique of laparoscopic pyeloplasty had been introduced for two decades [2]. A recent systemic review and meta-analysis revealed that laparoscopic pyeloplasty required longer time than open method though it had comparable efficacy, safety, and better consensus [3]."
Reasoning: The introduction describes the rationale for the review in the context of what is already known about pyeloplasty techniques in children.
[Yes]

P4
Reasoning: The authors do not provide an explicit statement of the review questions with reference to PICOS.
[No]

P5
Quote: "We used the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement to report our findings."
Reasoning: The authors mention using the PRISMA statement, but do not indicate if a review protocol exists or where it can be accessed.
[No]

P6
Quote: "We searched PubMed® for comparative studies (from January 1990 to 2014 September) that compared the efficacy and safety of robotic versus open pyeloplasty. Searches were limited to studies published in English."
Reasoning: The authors specify the databases, date range, and language of the search, but do not fully describe the study characteristics and report characteristics used as eligibility criteria.
[No]

P7
Quote: "We searched PubMed® for comparative studies (from January 1990 to 2014 September) that compared the efficacy and safety of robotic versus open pyeloplasty."
Reasoning: The authors describe searching PubMed up to September 2014, but do not mention other information sources.
[No]

P8
Reasoning: The authors do not present the full electronic search strategy for any database.
[No]

P9
Quote: "The following criteria were used to filter studies for our analysis: randomized controlled trials or comparative studies that compared children who received either robotic or open dismembered pyeloplasty for ureteropelvic junction obstruction with data on perioperative parameters, complication rate, and success rate."
Reasoning: The authors describe the criteria used to select studies for inclusion, but do not fully describe the process of study selection.
[No]

P10
Reasoning: The authors do not describe the method of data extraction in detail.
[No]

P11
Reasoning: The authors do not provide a list of all variables for which data were sought.
[No]

P12
Reasoning: The authors mention assessing study quality but do not describe the methods used.
[No]

P13
Quote: "We analyzed the dichotomous outcomes using risk ratios (RRs) as the summary statistic."
Reasoning: The authors state that they used risk ratios as the summary measure for dichotomous outcomes.
[Yes]

P14
Quote: "We analyzed the dichotomous outcomes using risk ratios (RRs) as the summary statistic. Chi-square statistical tests (Q statistics) and the I2 test were used to test the heterogeneity between the trials."
Reasoning: The authors describe the methods used for the meta-analysis, including the summary statistic and assessment of heterogeneity.
[Yes]

P15
Quote: "We analyzed the possible publication bias by generating funnel plots of the trials used for all of the evaluated comparisons of outcomes."
Reasoning: The authors describe assessing publication bias using funnel plots.
[Yes]

P16
Reasoning: The authors do not describe any additional analyses.
[No]

P17
Quote: Figure 1 shows a flowchart of study selection with the number of studies screened, assessed for eligibility, and included, with reasons for exclusions at each stage.
Reasoning: The flowchart provides the required information on study selection.
[Yes]

P18
Quote: "Totally, seven retrospective comparative trials [9–15] and three studies [4, 16, 17] using national database were included. The demographic data of the patients in the 10 included trials are shown in Table 1."
Reasoning: The authors state the number of included studies and provide an aggregated table of their characteristics.
[Yes]

P19
Reasoning: The authors do not present the risk of bias for each included study.
[No]

P20
Reasoning: The authors do not present the individual study results with a summary of the data for each intervention group.
[No]

P21
Reasoning: The authors report the results of the meta-analyses, including the pooled effect estimates and confidence intervals, but do not include measures of consistency for each analysis.
[No]

P22
Reasoning: The authors do not present the results of the risk of bias assessment across studies.
[No]

P23
Reasoning: The authors do not report any additional analyses.
[No]

P24
Quote: "Despite the wide acceptance of robotic surgery in adults, open pyeloplasty remained the mainstay of surgical option in treating children with UPJO. According to the national database analysis, the trends of performing robotic-assisted pyeloplasty are increasing in the recent years, while the proportion still remained low [7]. Our systemic review did not find any randomized control trials or prospective observational trials comparing RP with the gold standard OP. Until now, there were only seven comparative studies, and three studies using national database to compare these two methods can be searched on PubMed."
Reasoning: The authors provide a summary of the main findings and their relevance to key groups in the discussion.
[Yes]

P25
Quote: "Although robotics bears the advantage of better intracorporeal suture and minimal invasiveness with pyeloplasty. The major drawback of stentless pyeloplasty was a higher rate of urinoma formation [24, 25]."
Reasoning: The authors discuss some limitations of robotic pyeloplasty, but do not fully address limitations at the study, outcome, and review levels.
[No]

P26
Quote: "The meta-analysis done by Cundy et al. [22] showed a borderline significantly lower estimated blood loss in RP group and no instance of blood transfusion was required. Usually, blood transfusion is rare in children undergoing pyeloplasty. However, the national survey of RP reported higher risks of blood transfusions in the RP group (1.2 %) than in OP (0.4 %) [4], which may reflect the real world of surgery done by general pediatric urologists, while the reported case–control series were reported by experienced laparoendoscopists. In general, the very narrow operation site, especially in children, which could prolong the learning curve for this robotic intervention, might cause practice, the higher transfusion, and complication rates in RP group. Moreover, it is likely that surgeons performed most of the robotic cases in their early learning phase. Lastly, the chance of technical error of robotics was around 5 %, in which conversion to standard laparoscopic pyeloplasty is required which highlights the need of keeping laparoscopic skills in performing robotic surgery [11]."
Reasoning: The authors provide an interpretation of the results in the context of other evidence and discuss implications for future research.
[Yes]

P27
Reasoning: The authors do not describe the sources of funding for the systematic review.
[No]

78. Chen 2013: Transanal endorectal pull-through versus transabdominal approach for Hirschsprung’s disease: A systematic review and meta-analysis

LLM response

26 quote(s) from publication full text (mean similarity 96.6%)

A1
Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: "Hirschsprung's disease," "perineal," "transanal," "transabdominal" and "pull-through.""
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
Quotes: "There was no difference in incidence of postoperative enterocolitis. Where postoperative soiling was reported, this was considered as equivalent to incontinence, as no study reported both outcomes simultaneously."
"Our review was limited to published studies and no contact with authors was made to obtain unpublished data."
Reasoning: The authors do not mention duplicate study selection and data extraction.
[No]

A3
Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: "Hirschsprung's disease," "perineal," "transanal," "transabdominal" and "pull-through." The reference lists of the full articles were also manually searched to identify additional eligible studies. After identifying relevant titles and abstracts, the studies were assessed for eligibility for inclusion in our meta-analysis."
Reasoning: At least 2 electronic databases were searched and the search was supplemented by checking reference lists.
[Yes]

A4
Quote: "After identifying relevant titles and abstracts, the studies were assessed for eligibility for inclusion in our meta-analysis. All studies included in the meta-analysis were published in English, although no language restriction was imposed."
Reasoning: The authors state that no language restriction was imposed, implying they searched for reports regardless of publication status.
[Yes]

A5
Quote: "Of 93 studies reporting the outcome of the transanal approach in treating Hirschsprung's disease, 18 studies that compared outcome after TERPT with those after TAB were eligible for inclusion in our analysis. Two studies used a different methodology for assessment of comparative results from other studies and were excluded [26,27]. Four studies contained data that overlapped with later studies from the same centers [13,25,28,29], leaving 1 RCT and 11 OCS for meta-analysis [10,14–24] (Fig. 1)."
Reasoning: The authors provide the number of included and excluded studies with reasons for exclusions.
[Yes]

A6
Quote: "Our study included 792 patients; 444 underwent TERPT and 348 underwent TAB (including 215 Soave from eight studies, 94 Duhamel from five studies, 24 Swenson from two studies and 15 Rehbein procedures from one study). Almost all TERPTs were done as single-stage procedures while staged procedures with preoperative colostomy were common in many TABs (Table 1). In two studies, three groups (TERPT, single- and multi-stage TAB) were compared to each other; for these, we analyzed the single-stage TAB for comparison with TERPT [16,22]."
Reasoning: The authors provide aggregated data on the participants, interventions and outcomes of the included studies.
[Yes]

A7
Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
Reasoning: The scientific quality of the included studies was assessed independently by 3 reviewers.
[Yes]

A8
Quote: "There were significant differences in the age of patients and duration of follow-up between the two groups, that is, the TERPT group had younger patients and had a shorter duration of follow-up. Kim et al. [10] showed that postoperative continence, stooling and enterocolitis tended to improve over time. As such, the benefits of TERPT in functional outcomes could potentially be even greater with longer follow-up."
Reasoning: The authors consider the methodological quality and differences between studies when formulating their conclusions.
[Yes]

A9
Quotes: "Pooled odds ratios (OR) were calculated for dichotomous variables using the Mantel–Haenszel method. Pooled mean differences (MD) were measured for continuous variables using the inverse variance method in meta-analysis."
"Statistical heterogeneity was assessed using I2. A fixed-effects model was used if I2<50% and a random-effects model was used if I2≥50%. Statistical analysis was performed using Review Manager 5.1.0 (Cochrane Collaboration)."
Reasoning: Appropriate statistical methods were used to combine the findings of studies and assess heterogeneity.
[Yes]

A10
Reasoning: The authors do not mention assessing publication bias.
[No]

A11
Reasoning: The authors acknowledge sources of funding for the systematic review but do not report on the funding sources of the included studies.
[No]

P1
Quote: "Transanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease."
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2
Quote: "Aim: Transanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease. The benefits of TERPT over the conventional transabdominal approach (TAB) are still unclear. We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB.
Methods: Original articles published from 1998 to 2012 were searched from Medline, Embase, and Cochrane databases. Randomized controlled trials (RCT) and observational clinical studies (OCS) comparing TERPT and TAB were included. Outcomes evaluated included operative time, hospital stay and incidence of postoperative incontinence/soiling, constipation and enterocolitis. Pooled odds ratios (OR) were calculated for dichotomous variables; pooled mean differences (MD) were measured for continuous variables."
Reasoning: The abstract provides a structured summary including background, objectives, data sources, eligibility criteria, appraisal methods, results and conclusions.
[Yes]

P3
Quote: "Since the first description of aganglionosis in the myenteric plexus of the distal colon in congenital megacolon by Dalla Valle et al., a variety of surgical procedures have been described in an attempt to restore normal bowel function in Hirschsprung's disease (HD) [1–6]. For many years, surgical treatment of HD involved staged procedures; an initial diverting enterostomy was followed by definitive transabdominal pull-through surgery with subsequent closure of the colostomy. These multi-stage surgeries have gradually been replaced by the primary pull-through surgery in many centers [7]."
Reasoning: The introduction describes the rationale for the review in the context of the history and evolution of surgical treatments for Hirschsprung's disease.
[Yes]

P4
Quote: "We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB."
Reasoning: The objectives are stated but do not explicitly reference the PICOS elements.
[No]

P5
Reasoning: The authors do not mention the existence of a review protocol or registration.
[No]

P6
Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: "Hirschsprung's disease," "perineal," "transanal," "transabdominal" and "pull-through." The reference lists of the full articles were also manually searched to identify additional eligible studies. After identifying relevant titles and abstracts, the studies were assessed for eligibility for inclusion in our meta-analysis. All studies included in the meta-analysis were published in English, although no language restriction was imposed."
Reasoning: The authors specify the study characteristics used as eligibility criteria.
[Yes]

P7
Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: "Hirschsprung's disease," "perineal," "transanal," "transabdominal" and "pull-through.""
Reasoning: The information sources and dates of coverage are described but the date last searched is not provided.
[No]

P8
Reasoning: The authors do not present the full electronic search strategy such that it could be repeated.
[No]

P9
Quote: "After identifying relevant titles and abstracts, the studies were assessed for eligibility for inclusion in our meta-analysis."
Reasoning: The process for selecting studies is partially described but more details could have been provided.
[No]

P10
Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
Reasoning: The method of data extraction is described.
[Yes]

P11
Quote: "Outcomes evaluated included operative time, hospital stay and incidence of postoperative incontinence/soiling, constipation and enterocolitis."
Reasoning: The outcomes for which data were sought are defined but the review does not comprehensively list all variables.
[No]

P12
Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
Reasoning: The authors state the included studies were appraised but do not describe the methods used to assess risk of bias.
[No]

P13
Quote: "Pooled odds ratios (OR) were calculated for dichotomous variables using the Mantel–Haenszel method. Pooled mean differences (MD) were measured for continuous variables using the inverse variance method in meta-analysis."
Reasoning: The principal summary measures are stated.
[Yes]

P14
Quotes: "Pooled odds ratios (OR) were calculated for dichotomous variables using the Mantel–Haenszel method. Pooled mean differences (MD) were measured for continuous variables using the inverse variance method in meta-analysis."
"Statistical heterogeneity was assessed using I2. A fixed-effects model was used if I2<50% and a random-effects model was used if I2≥50%. Statistical analysis was performed using Review Manager 5.1.0 (Cochrane Collaboration)."
Reasoning: The methods of handling data and combining results are described, including the measures of consistency.
[Yes]

P15
Reasoning: The authors do not specify any assessment of risk of bias across studies that may affect the cumulative evidence.
[No]

P16
Reasoning: No additional analyses are described.
[NA]

P17
Quote: "Of 93 studies reporting the outcome of the transanal approach in treating Hirschsprung's disease, 18 studies that compared outcome after TERPT with those after TAB were eligible for inclusion in our analysis. Two studies used a different methodology for assessment of comparative results from other studies and were excluded [26,27]. Four studies contained data that overlapped with later studies from the same centers [13,25,28,29], leaving 1 RCT and 11 OCS for meta-analysis [10,14–24] (Fig. 1)."
Reasoning: The authors provide the number of studies screened, assessed for eligibility, and included with reasons for exclusions at each stage, accompanied by a flow diagram (Fig. 1).
[Yes]

P18
Quote: "Our study included 792 patients; 444 underwent TERPT and 348 underwent TAB (including 215 Soave from eight studies, 94 Duhamel from five studies, 24 Swenson from two studies and 15 Rehbein procedures from one study). Almost all TERPTs were done as single-stage procedures while staged procedures with preoperative colostomy were common in many TABs (Table 1). In two studies, three groups (TERPT, single- and multi-stage TAB) were compared to each other; for these, we analyzed the single-stage TAB for comparison with TERPT [16,22]."
Reasoning: The authors present the characteristics of each included study in an aggregated form in the text and in Table 1.
[Yes]

P19
Reasoning: The authors do not present data on the risk of bias of each study.
[No]

P20
Reasoning: Simple summary data for each group and effect estimates with confidence intervals are not provided for each study for all outcomes. Some of this information is provided in the forest plots but not comprehensively.
[No]

P21
Reasoning: The results of each meta-analysis are presented in the forest plots, including confidence intervals and measures of consistency.
[Yes]

P22
Reasoning: The authors do not present any assessment of risk of bias across studies.
[No]

P23
Reasoning: No additional analyses are described.
[NA]

P24
Quote: "Our meta-analysis suggests that the TERPT is superior to the conventional TAB pull-through for Hirschsprung's disease. To our knowledge, this study is the first systematic review and meta-analysis comparing TERPT to TAB pull-through for Hirschsprung's disease.
TERPT is a minimally invasive procedure, with the advantages of better cosmesis, less postoperative pain and avoidance of abdominal contamination [8]. Many studies have also suggested that TERPT reduces operative time and hospital stay compared to conventional open surgery, which is shown by our meta-analysis [14–19,22,24]. However, we note a significant heterogeneity among the studies for operative time and duration of hospital stay. This heterogeneity may be attributed to variation in the skills of the surgeons and differences in postoperative care pathways in different centers."
Reasoning: The authors summarize the main findings and their relevance to key groups.
[Yes]

P25
Quote: "All TERPT procedures were performed after 1996, while the earliest open procedure included in this meta-analysis was from 1990. In the intervening years, factors other than the surgical approach, such as improvements in pediatric perioperative care, management of complications, or even administration-driven attention to length of hospital stay, may have partially contributed to the apparent better outcomes in the TERPT group."
Reasoning: The authors discuss some limitations at the review level, such as differences between the TERPT and open procedure groups that could have influenced the findings.
[Yes]

P26
Quote: "Postoperative enterocolitis is one of the main complications after pull-through surgery. The reported incidence of postoperative enterocolitis in the literature ranges from 4.6% to 54% [32]. A recent review showed that the incidence of postoperative and recurrent enterocolitis was markedly lower in TERPT (10% and 2% respectively) [32]. Our meta-analysis also showed a tendency to a lower incidence of enterocolitis in the TERPT group compared with TAB, although the difference was not statistically significant."
Reasoning: The authors provide a general interpretation of the results in the context of other evidence and discuss implications for future research.
[Yes]

P27
Quote: "The authors would like to thank Mr. Fahad Javaid Siddiqui, Assistant Professor of Epidemiology, Singapore Clinical Research Institute, for his invaluable help with statistical analysis."
Reasoning: The authors acknowledge a source of support for the systematic review but do not describe the role of funders.
[No]

79. Corbett 2015: Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review

LLM response

13 quote(s) from publication full text (mean similarity 99.2%)

A1
"The study aimed to systematically analyse published literature to give an overall success rate for endopyelo tomy in children."
The objective of the review is clearly stated.
[Yes]

A2
No mention of duplicate study selection or data extraction.
[No]

A3
"Medline and Embase databases were searched using relevant key search terms (pelviu reteric junction, ureteropelvic junction, obstruction, paediatric, pediatric, child$, balloon, dilatation, endopyelo tomy, pyelo plasty). No publication date limits were applied and the final search was performed on 29 September 2014."
Multiple databases were searched with relevant terms. No supplementary search strategies were mentioned.
[No]

A4
No mention of including grey literature.
[No]

A5
Figure 1 shows a PRISMA flow diagram with the number of studies included and excluded at each stage.
[Yes]

A6
Table 1 provides the characteristics of the included studies in aggregate form.
[Yes]

A7
"References from the retrieved articles were also searched manually for additional relevant studies."
The scientific quality of included studies was not assessed.
[No]

A8
[NA]

A9
[NA]

A10
[NA]

A11
"None."
The review states there were no conflicts of interest.
[No]

P1
"Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review"
The title identifies the report as a systematic review.
[Yes]

P2
The abstract is structured with labeled sections for background, objective, study design, results, and conclusion. However, it is missing some recommended elements like data sources, participants, interventions, appraisal and synthesis methods, limitations, registration number.
[No]

P3
"Dismembered pyeloplasty is the gold standard treatment for pelviureteric obstruction (PUJO) although endourological techniques are also employed. Outcomes and success rates for paediatric endopyelotomy are variably reported."
The introduction describes the rationale for the review.
[Yes]

P4
"The study aimed to systematically analyse published literature to give an overall success rate for endopyelo tomy in children."
The objective is stated but does not fully reference the PICOS elements.
[No]

P5
No mention of a review protocol or registration.
[No]

P6
"Medline and Embase databases were searched using relevant key search terms to identify reports of paediatric endopyelo tomy. Literature reviews, case reports, series of <3 children and adult studies (age >20 years) were excluded."
Eligibility criteria related to study characteristics and report characteristics are provided with rationale.
[Yes]

P7
"Medline and Embase databases were searched using relevant key search terms (pelviu reteric junction, ureteropelvic junction, obstruction, paediatric, pediatric, child$, balloon, dilatation, endopyelo tomy, pyelo plasty). No publication date limits were applied and the final search was performed on 29 September 2014."
Information sources are described but the date last searched is not provided.
[No]

P8
The full search strategy is not presented.
[No]

P9
"All retrieved studies were evaluated for abstracts, and full papers were retrieved for articles that could not be rejected based on abstract alone. References from the retrieved articles were also searched manually for additional relevant studies."
The study selection process is described.
[Yes]

P10
"Literature reviews, individual case reports, exclusively adult studies (age >20 years), and small case series of fewer than three paediatric patients were excluded."
The data collection process is not adequately described.
[No]

P11
The data items sought are not defined.
[No]

P12
No description of assessing risk of bias in individual studies.
[No]

P13
[NA]

P14
[NA]

P15
[NA]

P16
[NA]

P17
"The initial search retrieved 242 titles. Once duplicate records had been excluded (n = 128), 114 titles were assessed for eligibility (Fig. 1). Following application of exclusion criteria and removal of duplicate data series, 15 studies were eligible to be included in the review [6–20]."
A flow diagram is provided with the numbers of studies at each stage and reasons for exclusions.
[Yes]

P18
Table 1 presents the characteristics of each included study with citations.
[Yes]

P19
No assessment of risk of bias within studies is reported.
[No]

P20
Table 1 provides outcome data for each study but does not include effect estimates and confidence intervals.
[No]

P21
[NA]

P22
[NA]

P23
[NA]

P24
The Discussion section summarizes the main findings.
[Yes]

P25
"This study is limited by the data given in the individual series: varied criteria used for patient selection and outcome as well as inconsistent pre and post operative imaging data precluded a metaanalysis. Designating procedures as failures if there were subsequent procedures to the PUJ lowered success rates from author-given figures for some studies. Complications rates after endopyelotomy are higher than those for open and minimally invasive pyeloplasty. Success rates for endopyelotomy do not compare favourably with pyeloplasty and crossing vessels should be excluded before considering the procedure."
Limitations at the study, outcome, and review level are discussed.
[Yes]

P26
"The study found success rates of 71% for primary endopyelotomy and 75% for secondary procedures, neither of which compare favourably with established outcome data for open and laparoscopic pyeloplasty. Crossing vessels are a significant concern in children with primary PUJO and should be excluded before considering endopyelotomy. Furthermore, due consideration must be given to the greater costs and complication rates associated with the procedure."
The conclusion provides a general interpretation of the results in the context of other evidence and implications for future research.
[Yes]

P27
"None."
Sources of funding and support are not described.
[No]

80. Cullis 2016: Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary?

LLM response

23 quote(s) from publication full text (mean similarity 98.7%)

A1
"A systematic review [according to PRISMA guidelines] was conducted using CINAHL, EMBASE, Medline, and Cochrane Databases. Article quality was assessed using MINORS criteria. Conference proceedings and unpublished data were screened additionally."
The authors mention using PRISMA guidelines, assessing study quality with MINORS, and screening conference proceedings and unpublished data, indicating an a priori design.
[Yes]

A2
No relevant quotes found.
No mention of duplicate study selection and data extraction.
[No]

A3
"A systematic review [according to PRISMA guidelines] was conducted using CINAHL, EMBASE, Medline, and Cochrane Databases, from inception to January 11, 2015 (the search was again updated through the reference listings of those articles yielded through the initial electronic database search. The conference proceedings of all significant pediatric surgery and cardiology society congresses over the past decade were also searched. Finally, data regarding patients with thoracotomy from our own institution were also obtained. Eligibility criteria were then applied to remaining studies (Table 1)."
Searching 4 databases, reference lists, conference proceedings, and own institutional data represents a comprehensive search.
[Yes]

A4
"Conference proceedings and unpublished data were screened additionally."
Screening conference proceedings and unpublished data indicates inclusion of grey literature.
[Yes]

A5
No relevant quotes found.
No list of included and excluded studies provided.
[No]

A6
See Table 2 for characteristics of included studies.
Table 2 provides the characteristics of the included studies.
[Yes]

A7
"Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria,27 in addition for all sources of data by a local checklist (including reporting of symptoms, imaging, surgeries, morbidity, mortality, and so on). Bias was assessed at study and summary levels."
Use of the MINORS criteria and a local checklist to assess study quality.
[Yes]

A8
"The evidence base for screening "asymptomatic" patients is weak especially considering the life-limiting comorbidities."
The authors consider the weak evidence base when formulating their conclusion about screening asymptomatic patients.
[Yes]

A9
Not applicable, no meta-analysis performed.
[NA]

A10
Not applicable, no meta-analysis performed.
[NA]

A11
No relevant quotes found.
No disclosure of funding sources or conflicts of interest for the systematic review or included studies.
[No]

P1
"Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary? A Systematic Review in Search of the Evidence"
The title identifies the article as a systematic review.
[Yes]

P2
The abstract is structured with labeled sections for Objective, Summary of Background Data, Methods, Results, and Conclusion.
The abstract is structured with the required sections.
[Yes]

P3
"Heterotaxy is an abnormal arrangement of thoraco-abdominal viscera across a left-to-right axis in contrast to normal patterning of "situs solitus." Traditionally, a mirror-image pattern of arrangement was included in the definition, but this so-called "situs inversus" is now considered separately."
The introduction provides rationale by describing heterotaxy and how it differs from situs solitus and situs inversus.
[Yes]

P4
"(1) Is screening of intestinal rotational anatomy obligatory in "asymptomatic" patients with heterotaxy? (2) Does detection of an anomaly warrant surgical correction?"
The introduction explicitly states the review questions.
[Yes]

P5
No relevant quotes found.
No mention of a review protocol or registration number.
[No]

P6
See Table 1 for inclusion and exclusion criteria.
Table 1 specifies the study characteristics used as eligibility criteria.
[Yes]

P7
"A systematic review [according to PRISMA guidelines] was conducted using CINAHL, EMBASE, Medline, and Cochrane Databases, from inception to January 11, 2015 (the search was again updated through the reference listings of those articles yielded through the initial electronic database search. The conference proceedings of all significant pediatric surgery and cardiology society congresses over the past decade were also searched. Finally, data regarding patients with thoracotomy from our own institution were also obtained."
The information sources searched are described, including databases with dates, reference lists, conference proceedings, and the authors' own institution.
[Yes]

P8
No relevant quotes found.
The full search strategy is not presented for any of the databases.
[No]

P9
"Eligibility criteria were then applied to remaining studies (Table 1)."
The study selection process of applying eligibility criteria is mentioned.
[Yes]

P10
"The primary outcome evaluated was mortality associated with conservative or surgical management of IRA. Secondary outcomes included development of malrotation with obstruction or midgut volvulus, that is, symptomatic IRA and complications thereof with surgical intervention."
Data extraction of primary and secondary outcomes is described.
[Yes]

P11
No relevant quotes found.
The data items sought are not defined.
[No]

P12
"Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria,27 in addition for all sources of data by a local checklist (including reporting of symptoms, imaging, surgeries, morbidity, mortality, and so on). Bias was assessed at study and summary levels."
Assessment of risk of bias in individual studies using MINORS and a local checklist is described.
[Yes]

P13
Not applicable, no meta-analysis performed.
[NA]

P14
Not applicable, no meta-analysis performed.
[NA]

P15
Not applicable, no meta-analysis performed.
[NA]

P16
Not applicable, no additional analyses performed.
[NA]

P17
See Figure 1 for a flow diagram of study selection.
A flow diagram of the study screening and selection process is provided.
[Yes]

P18
See Table 2 for characteristics of included studies with citations.
Table 2 presents the characteristics of each included study along with citations.
[Yes]

P19
See Figure 1 for risk of bias assessments using MINORS.
Figure 1 presents the risk of bias assessments for each included study using MINORS.
[Yes]

P20
See Table 3 for individual study results.
Table 3 provides the results for each individual study.
[Yes]

P21
Not applicable, no meta-analysis performed.
[NA]

P22
Not applicable, no meta-analysis performed.
[NA]

P23
Not applicable, no additional analyses performed.
[NA]

P24
"The evidence base for screening "asymptomatic" patients is weak especially considering the life-limiting comorbidities."
The main findings and strength of evidence are summarized.
[Yes]

P25
"Although this systematic review favors a "watchful waiting" approach over prophylactic surgery in patients with heterotaxy, what exactly this should constitute is not standardized. Those 5 papers advocating a conservative approach of the asymptomatic patients emphasize the need for "regular" or "close" follow-up, and where this is not possible, or when symptoms develop, imaging is warranted."
Limitations such as lack of standardization of the watchful waiting approach are discussed.
[Yes]

P26
"We fully acknowledge that there are some limitations with the present study. Follow-up reporting data in studies we analyzed was sometimes poor. This may influence long-term outcome(s) of both a "watchful waiting" policy and operative intervention. Adequate reporting in studies was thus by no means always satisfactory. MINORS scoring highlighted these fact(s) (Fig. 1). Here, we found that little reference was made in many studies as to the nature of cardiac comorbidity(s) and cardiac mortality out with the perioperative period. It is heart anomalies, which most often are the determinant of life expectancy guiding the appropriateness of surgical correction of IRA. All studies included were retrospective observational studies with no valid comparator group (Oxford EBM—Level IV evidence32). As a result, there were some significant inherent bias(s) indicating interpretation of studies with care."
The authors acknowledge limitations with the data and studies analyzed.
[Yes]

P27
No relevant quotes found.
No description of funding sources.
[No]

82. Cundy 2014 (J Pediatr Surg): Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children

LLM response

42 quote(s) from publication full text (mean similarity 90.1%)

A1
Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
Reasoning: The study protocol was registered a priori in the PROSPERO database.
[Yes]

A2
Quotes: "Four authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by discussion with the senior author (AD). Corresponding authors were contacted regarding any missing data. The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]."
Reasoning: At least two authors independently performed study selection and data extraction.
[Yes]

A3
Quotes: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "infant"[MeSH] OR "child"[MeSH] OR "adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH]). The search period was defined as June 2001 to June 2013 inclusively. The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword "fundoplication", and 3) abstracts of the annual meetings of the International Pediatric Endosurgery Group."
Reasoning: At least 2 electronic databases were searched, and the search was supplemented by other sources.
[Yes]

A4
Quotes: "The search period was defined as June 2001 to June 2013 inclusively. The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword "fundoplication", and 3) abstracts of the annual meetings of the International Pediatric Endosurgery Group."
Reasoning: The search included the clinicaltrials.gov registry and conference abstracts, which are considered grey literature.
[Yes]

A5
Quote: "Fig. 1. Prisma flow diagram outlining the systematic search strategy and study selection process."
Reasoning: A PRISMA flow diagram is provided showing the number of included and excluded studies at each stage of the selection process.
[Yes]

A6
Quote: "Table 1 Characteristics of studies included in the meta-analysis."
Reasoning: A table of characteristics of included studies is provided, including study design, study period, sample sizes, and other details.
[Yes]

A7
Quotes: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]." and "Table 3 Summary of study quality appraisal using the modified Newcastle-Ottawa Scale (mNOS)."
Reasoning: A modified Newcastle-Ottawa Scale was used to assess the quality of included studies, and the results are reported in a table.
[Yes]

A8
Quote: "The majority of comparative effectiveness literature is comprised of small retrospective studies with historical controls. The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders. Many important outcome variables also remain unaccounted for in the literature. More high quality prospective studies and clinical trials are indisputably warranted to better inform the debate of RF versus LF for fundoplication in children."
Reasoning: The limitations of the included studies and their impact on the conclusions are discussed.
[Yes]

A9
Quotes: "Heterogeneity, Tau2 = 4.48; Chi2 = 16.57; df = 4 (P = 0.002); I2 = 76%" and "Heterogeneity, Tau2 = 17.01; Chi2 = 4.10; df = 2 (P = 0.13); I2 = 51%"
Reasoning: Heterogeneity was assessed using the I2 statistic for each meta-analysis. A random effects model was used.
[Yes]

A10
Reasoning: Publication bias was not assessed, likely because there were fewer than 10 studies in the meta-analyses.
[NA]

A11
Reasoning: Conflicts of interest and funding sources are not reported for the included studies.
[No]

P1
Quote: "Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children"
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2
Reasoning: The article has a structured abstract with labeled sections for background, methods, results, and conclusions.
[Yes]

P3
Quote: "Minimally invasive fundoplication may be performed using either a robot-assisted (RF) or conventional laparoscopic (LF) technique. Evidence comparing RF and LF in children remains unclear. This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
Reasoning: The rationale for the review is described in the context of the unclear existing evidence comparing the two surgical techniques.
[Yes]

P4
Quote: "This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
Reasoning: The objectives are stated, though without explicit reference to PICOS elements.
[Yes]

P5
Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
Reasoning: Registration of the review protocol in the PROSPERO database is reported.
[Yes]

P6
Quotes: "All included studies satisfied the following criteria: 1) comparing robot-assisted (RF) versus conventional laparoscopic fundoplication (LF), 2) involving pediatric patients with mean or median study group ages < 18 years, 3) reporting ≥ 5 patients in each study group, and 4) investigating either objective clinical outcome measures or GERD symptoms via standardized questionnaires. No language restrictions were imposed. In the event that duplication of data was observed, more recent studies or those with larger sample sizes were preferentially considered, with subsequent exclusion of earlier, smaller studies."
Reasoning: The eligibility criteria are specified, including study characteristics (comparator, population, outcomes) and report characteristics (language).
[Yes]

P7
Quotes: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "infant"[MeSH] OR "child"[MeSH] OR "adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH]). The search period was defined as June 2001 to June 2013 inclusively. The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword "fundoplication", and 3) abstracts of the annual meetings of the International Pediatric Endosurgery Group."
Reasoning: All information sources searched are described, including the databases with dates of coverage and the date last searched.
[Yes]

P8
Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "infant"[MeSH] OR "child"[MeSH] OR "adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH])."
Reasoning: The full search strategy is provided for the PubMed database.
[Yes]

P9
Quote: "Four authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by discussion with the senior author (AD)."
Reasoning: The process for selecting studies, including screening and eligibility assessment, is described.
[Yes]

P10
Quote: "Corresponding authors were contacted regarding any missing data. The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]."
Reasoning: The data collection process is described, including contacting authors for missing data and using a scale to extract data on methodological quality.
[Yes]

P11
Reasoning: The specific variables for which data were sought are not explicitly defined, though some are implied in the eligibility criteria and quality assessment.
[No]

P12
Quote: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]."
Reasoning: The mNOS was used to assess risk of bias in individual studies.
[Yes]

P13
Quotes: "WMD 11.2 minutes; 95% CI 1.85 to 20.55; P = 0.02" and "WMD = 19.35 minutes; 95% CI 19.03 to 46.94; P = 0.41"
Reasoning: The weighted mean difference (WMD) was used as a summary measure for continuous outcomes like operating time.
[Yes]

P14
Quotes: "Heterogeneity, Tau2 = 4.48; Chi2 = 16.57; df = 4 (P = 0.002); I2 = 76%" and "Heterogeneity, Tau2 = 17.01; Chi2 = 4.10; df = 2 (P = 0.13); I2 = 51%"
Reasoning: Random effects meta-analysis models were used. Heterogeneity was assessed using the I2 statistic.
[Yes]

P15
Reasoning: Assessment of risk of bias across studies, such as publication bias, was not described.
[No]

P16
Quotes: "Sub-group analysis of high quality studies only (mNOS ≥ 7.8 median mNOS score for included studies) was performed to assess the impact of study quality on pooled estimate (Fig. 6a, WMD = 15.97 minutes; 95% CI 18.55 to 50.49; P = 0.36)." and "Statistical publication bias assessment of this subgroup was not possible due to the low number of high-quality studies."
Reasoning: A subgroup analysis of only high-quality studies was performed as an additional analysis.
[Yes]

P17
Quote: "Fig. 1. Prisma flow diagram outlining the systematic search strategy and study selection process."
Reasoning: A PRISMA flow diagram is provided showing the numbers of studies screened, assessed for eligibility, included, and excluded with reasons at each stage.
[Yes]

P18
Quote: "Table 1 Characteristics of studies included in the meta-analysis."
Reasoning: A table of characteristics of included studies is provided, with citations.
[Yes]

P19
Quote: "Table 3 Summary of study quality appraisal using the modified Newcastle-Ottawa Scale (mNOS)."
Reasoning: The results of the risk of bias assessments for each included study using the mNOS are presented in a table.
[Yes]

P20
Reasoning: Simple summary data for each group and effect estimates with confidence intervals are not presented for each study for all outcomes.
[No]

P21
Quotes: "Heterogeneity, Tau2 = 4.48; Chi2 = 16.57; df = 4 (P = 0.002); I2 = 76%" and "Heterogeneity, Tau2 = 17.01; Chi2 = 4.10; df = 2 (P = 0.13); I2 = 51%"
Reasoning: The results of each meta-analysis are presented, including the effect estimates, confidence intervals, and I2 values as a measure of heterogeneity.
[Yes]

P22
Reasoning: The results of the risk of bias assessment across studies was not presented, as this was not assessed.
[NA]

P23
Quote: "Sub-group analysis of high quality studies only (mNOS ≥ 7.8 median mNOS score for included studies) was performed to assess the impact of study quality on pooled estimate (Fig. 6a, WMD = 15.97 minutes; 95% CI 18.55 to 50.49; P = 0.36)."
Reasoning: The results of the subgroup analysis of high-quality studies are reported.
[Yes]

P24
Quotes: "Meta-analysis of the current literature identifies comparable safety and short-term efficacy for robot-assisted laparoscopic fundoplication when compared to conventional laparoscopic fundoplication in children. However, there is insufficient evidence to assess comparative effectiveness for important procedure and pathology specific outcome measures such as success rate, post-operative surgery related morbidity and re-operation rates." and "The majority of comparative effectiveness literature is comprised of small retrospective studies with historical controls. The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders."
Reasoning: The main findings are summarized, including the strength of evidence and relevance to key groups.
[Yes]

P25
Quotes: "The majority of comparative effectiveness literature is comprised of small retrospective studies with historical controls. The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders. Many important outcome variables also remain unaccounted for in the literature." and "Randomized controlled trials are considered the gold-standard method of comparative assessment for new surgical techniques and technology. Recognized difficulties to undertaking RCTs within surgical disciplines are heightened in pediatric surgery by additional ethical and scientific challenges [32]. It should be noted that amongst the small < 0.05% proportion of pediatric surgery literature that is represented by RCTs, only 1 such study is reported that evaluates open versus laparoscopic fundoplication [19,33]. In addition to generalizable barriers to undertaking clinical trials in surgery, pursuit of prospective comparative studies or trials in this field might be faced with local pressure from hospital management or other stakeholders presently available outcome and economic data."
Reasoning: Limitations at the study and outcome level (retrospective designs, bias, unknown confounders) and at the review level (limited RCTs in pediatric surgery) are discussed.
[Yes]

P26
Quote: "From an exclusively evidence-based standpoint, it is challenging to robustly defend a cost-benefit argument for RF in the context of current data."
Reasoning: A general interpretation of the results in the context of other evidence is provided, along with implications for future research (the need for cost-effectiveness analysis).
[Yes]

P27
Reasoning: Sources of funding for the systematic review are not described, and the role of any funders is not mentioned.
[No]

83. Cundy 2014 (Eur J Pediatr Surg): Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

LLM response

42 quote(s) from publication full text (mean similarity 90.1%)

A1
Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
Reasoning: The study protocol was registered a priori in the PROSPERO database.
[Yes]

A2
Quotes: "Four authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by discussion with the senior author (AD). Corresponding authors were contacted regarding any missing data. The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]."
Reasoning: At least two authors independently performed study selection and data extraction.
[Yes]

A3
Quotes: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "infant"[MeSH] OR "child"[MeSH] OR "adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH]). The search period was defined as June 2001 to June 2013 inclusively. The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword "fundoplication", and 3) abstracts of the annual meetings of the International Pediatric Endosurgery Group."
Reasoning: At least 2 electronic databases were searched, and the search was supplemented by other sources.
[Yes]

A4
Quotes: "The search period was defined as June 2001 to June 2013 inclusively. The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword "fundoplication", and 3) abstracts of the annual meetings of the International Pediatric Endosurgery Group."
Reasoning: The search included the clinicaltrials.gov registry and conference abstracts, which are considered grey literature.
[Yes]

A5
Quote: "Fig. 1. Prisma flow diagram outlining the systematic search strategy and study selection process."
Reasoning: A PRISMA flow diagram is provided showing the number of included and excluded studies at each stage of the selection process.
[Yes]

A6
Quote: "Table 1 Characteristics of studies included in the meta-analysis."
Reasoning: A table of characteristics of included studies is provided, including study design, study period, sample sizes, and other details.
[Yes]

A7
Quotes: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]." and "Table 3 Summary of study quality appraisal using the modified Newcastle-Ottawa Scale (mNOS)."
Reasoning: A modified Newcastle-Ottawa Scale was used to assess the quality of included studies, and the results are reported in a table.
[Yes]

A8
Quote: "The majority of comparative effectiveness literature is comprised of small retrospective studies with historical controls. The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders. Many important outcome variables also remain unaccounted for in the literature. More high quality prospective studies and clinical trials are indisputably warranted to better inform the debate of RF versus LF for fundoplication in children."
Reasoning: The limitations of the included studies and their impact on the conclusions are discussed.
[Yes]

A9
Quotes: "Heterogeneity, Tau2 = 4.48; Chi2 = 16.57; df = 4 (P = 0.002); I2 = 76%" and "Heterogeneity, Tau2 = 17.01; Chi2 = 4.10; df = 2 (P = 0.13); I2 = 51%"
Reasoning: Heterogeneity was assessed using the I2 statistic for each meta-analysis. A random effects model was used.
[Yes]

A10
Reasoning: Publication bias was not assessed, likely because there were fewer than 10 studies in the meta-analyses.
[NA]

A11
Reasoning: Conflicts of interest and funding sources are not reported for the included studies.
[No]

P1
Quote: "Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children"
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2
Reasoning: The article has a structured abstract with labeled sections for background, methods, results, and conclusions.
[Yes]

P3
Quote: "Minimally invasive fundoplication may be performed using either a robot-assisted (RF) or conventional laparoscopic (LF) technique. Evidence comparing RF and LF in children remains unclear. This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
Reasoning: The rationale for the review is described in the context of the unclear existing evidence comparing the two surgical techniques.
[Yes]

P4
Quote: "This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
Reasoning: The objectives are stated, though without explicit reference to PICOS elements.
[Yes]

P5
Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
Reasoning: Registration of the review protocol in the PROSPERO database is reported.
[Yes]

P6
Quotes: "All included studies satisfied the following criteria: 1) comparing robot-assisted (RF) versus conventional laparoscopic fundoplication (LF), 2) involving pediatric patients with mean or median study group ages < 18 years, 3) reporting ≥ 5 patients in each study group, and 4) investigating either objective clinical outcome measures or GERD symptoms via standardized questionnaires. No language restrictions were imposed. In the event that duplication of data was observed, more recent studies or those with larger sample sizes were preferentially considered, with subsequent exclusion of earlier, smaller studies."
Reasoning: The eligibility criteria are specified, including study characteristics (comparator, population, outcomes) and report characteristics (language).
[Yes]

P7
Quotes: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "infant"[MeSH] OR "child"[MeSH] OR "adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH]). The search period was defined as June 2001 to June 2013 inclusively. The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword "fundoplication", and 3) abstracts of the annual meetings of the International Pediatric Endosurgery Group."
Reasoning: All information sources searched are described, including the databases with dates of coverage and the date last searched.
[Yes]

P8
Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "infant"[MeSH] OR "child"[MeSH] OR "adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH])."
Reasoning: The full search strategy is provided for the PubMed database.
[Yes]

P9
Quote: "Four authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by discussion with the senior author (AD)."
Reasoning: The process for selecting studies, including screening and eligibility assessment, is described.
[Yes]

P10
Quote: "Corresponding authors were contacted regarding any missing data. The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]."
Reasoning: The data collection process is described, including contacting authors for missing data and using a scale to extract data on methodological quality.
[Yes]

P11
Reasoning: The specific variables for which data were sought are not explicitly defined, though some are implied in the eligibility criteria and quality assessment.
[No]

P12
Quote: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]."
Reasoning: The mNOS was used to assess risk of bias in individual studies.
[Yes]

P13
Quotes: "WMD 11.2 minutes; 95% CI 1.85 to 20.55; P = 0.02" and "WMD = 19.35 minutes; 95% CI 19.03 to 46.94; P = 0.41"
Reasoning: The weighted mean difference (WMD) was used as a summary measure for continuous outcomes like operating time.
[Yes]

P14
Quotes: "Heterogeneity, Tau2 = 4.48; Chi2 = 16.57; df = 4 (P = 0.002); I2 = 76%" and "Heterogeneity, Tau2 = 17.01; Chi2 = 4.10; df = 2 (P = 0.13); I2 = 51%"
Reasoning: Random effects meta-analysis models were used. Heterogeneity was assessed using the I2 statistic.
[Yes]

P15
Reasoning: Assessment of risk of bias across studies, such as publication bias, was not described.
[No]

P16
Quotes: "Sub-group analysis of high quality studies only (mNOS ≥ 7.8 median mNOS score for included studies) was performed to assess the impact of study quality on pooled estimate (Fig. 6a, WMD = 15.97 minutes; 95% CI 18.55 to 50.49; P = 0.36)." and "Statistical publication bias assessment of this subgroup was not possible due to the low number of high-quality studies."
Reasoning: A subgroup analysis of only high-quality studies was performed as an additional analysis.
[Yes]

P17
Quote: "Fig. 1. Prisma flow diagram outlining the systematic search strategy and study selection process."
Reasoning: A PRISMA flow diagram is provided showing the numbers of studies screened, assessed for eligibility, included, and excluded with reasons at each stage.
[Yes]

P18
Quote: "Table 1 Characteristics of studies included in the meta-analysis."
Reasoning: A table of characteristics of included studies is provided, with citations.
[Yes]

P19
Quote: "Table 3 Summary of study quality appraisal using the modified Newcastle-Ottawa Scale (mNOS)."
Reasoning: The results of the risk of bias assessments for each included study using the mNOS are presented in a table.
[Yes]

P20
Reasoning: Simple summary data for each group and effect estimates with confidence intervals are not presented for each study for all outcomes.
[No]

P21
Quotes: "Heterogeneity, Tau2 = 4.48; Chi2 = 16.57; df = 4 (P = 0.002); I2 = 76%" and "Heterogeneity, Tau2 = 17.01; Chi2 = 4.10; df = 2 (P = 0.13); I2 = 51%"
Reasoning: The results of each meta-analysis are presented, including the effect estimates, confidence intervals, and I2 values as a measure of heterogeneity.
[Yes]

P22
Reasoning: The results of the risk of bias assessment across studies was not presented, as this was not assessed.
[NA]

P23
Quote: "Sub-group analysis of high quality studies only (mNOS ≥ 7.8 median mNOS score for included studies) was performed to assess the impact of study quality on pooled estimate (Fig. 6a, WMD = 15.97 minutes; 95% CI 18.55 to 50.49; P = 0.36)."
Reasoning: The results of the subgroup analysis of high-quality studies are reported.
[Yes]

P24
Quotes: "Meta-analysis of the current literature identifies comparable safety and short-term efficacy for robot-assisted laparoscopic fundoplication when compared to conventional laparoscopic fundoplication in children. However, there is insufficient evidence to assess comparative effectiveness for important procedure and pathology specific outcome measures such as success rate, post-operative surgery related morbidity and re-operation rates." and "The majority of comparative effectiveness literature is comprised of small retrospective studies with historical controls. The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders."
Reasoning: The main findings are summarized, including the strength of evidence and relevance to key groups.
[Yes]

P25
Quotes: "The majority of comparative effectiveness literature is comprised of small retrospective studies with historical controls. The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders. Many important outcome variables also remain unaccounted for in the literature." and "Randomized controlled trials are considered the gold-standard method of comparative assessment for new surgical techniques and technology. Recognized difficulties to undertaking RCTs within surgical disciplines are heightened in pediatric surgery by additional ethical and scientific challenges [32]. It should be noted that amongst the small < 0.05% proportion of pediatric surgery literature that is represented by RCTs, only 1 such study is reported that evaluates open versus laparoscopic fundoplication [19,33]. In addition to generalizable barriers to undertaking clinical trials in surgery, pursuit of prospective comparative studies or trials in this field might be faced with local pressure from hospital management or other stakeholders presently available outcome and economic data."
Reasoning: Limitations at the study and outcome level (retrospective designs, bias, unknown confounders) and at the review level (limited RCTs in pediatric surgery) are discussed.
[Yes]

P26
Quote: "From an exclusively evidence-based standpoint, it is challenging to robustly defend a cost-benefit argument for RF in the context of current data."
Reasoning: A general interpretation of the results in the context of other evidence is provided, along with implications for future research (the need for cost-effectiveness analysis).
[Yes]

P27
Reasoning: Sources of funding for the systematic review are not described, and the role of any funders is not mentioned.
[No]

84. Ding 2013: Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis

LLM response

22 quote(s) from publication full text (mean similarity 97.6%)

A1
"The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012. The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or"
The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
No relevant quotes found.
The authors did not mention using at least two independent data extractors and a consensus procedure.
[No]

A3
"The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012."
The authors searched at least two electronic databases (MEDLINE, EMBASE, Cochrane Library).
[Yes]

A4
No relevant quotes found.
The authors did not state that they searched for reports regardless of publication type or whether they excluded any reports based on publication status, language, etc.
[No]

A5
No relevant quotes found.
The authors did not provide a list of included and excluded studies.
[No]

A6
"The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1."
The authors provided the characteristics of the included studies in an aggregated table.
[Yes]

A7
"Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29]."
The authors used a star scoring system to assess the quality of included studies.
[Yes]

A8
"Compared with TILA, SILA has the advantage of shorter hospital stay, and it can achieve comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs. Whether it can achieve improvement in cosmesis remains to be confirmed."
The authors considered the methodological quality when formulating the conclusions of the review.
[Yes]

A9
No relevant quotes found.
The authors did not combine the findings of the studies in a meta-analysis.
[NA]

A10
No relevant quotes found.
The authors did not assess the likelihood of publication bias.
[NA]

A11
No relevant quotes found.
The authors did not report the sources of support or conflicts of interest for the systematic review and the included studies.
[No]

P1
"Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis"
The report is identified as a systematic review and meta-analysis in the title.
[Yes]

P2
The abstract is structured with labeled sections for Background, Materials and Methods, Results, and Conclusions.
[Yes]

P3
"Single-incision laparoscopic surgery (SILS) is the novel member of the minimally invasive surgery [4], it's a new innovation allowing minimal invasive surgery to be performed through a single umbilical incision, and it can further reduce the trauma of surgical access [5]."
The rationale for the review is described in the context of what is already known about SILS.
[Yes]

P4
No relevant quotes found.
The authors did not provide an explicit statement of the review questions being addressed in terms of PICOS.
[No]

P5
No relevant quotes found.
The authors did not indicate if a review protocol exists or where it can be accessed.
[No]

P6
"The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or"
The authors specified the study characteristics used as criteria for eligibility.
[Yes]

P7
"The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012."
The authors described the information sources searched and the date range covered.
[Yes]

P8
No relevant quotes found.
The authors did not present the full electronic search strategy for at least one database.
[No]

P9
"The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012. The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or"
The authors stated the process for selecting studies.
[Yes]

P10
"Three researchers extracted data from each study by using a structured sheet and entered the data into a database. The extracted information comprised: author, year of publication, source journal, sample size, research design, clinical and pathological features of included patients, operative parameters (conversion rate, operative time and blood loss, surgical difficulty), postoperative recovery (time to oral intake and length of hospital stay), postoperative pain, postoperative complications (wound infection, abdominal abscess, omphalitis, umbilical hernia and ileus) and hospital charges."
The authors described the method of data extraction from reports.
[Yes]

P11
"The extracted information comprised: author, year of publication, source journal, sample size, research design, clinical and pathological features of included patients, operative parameters (conversion rate, operative time and blood loss, surgical difficulty), postoperative recovery (time to oral intake and length of hospital stay), postoperative pain, postoperative complications (wound infection, abdominal abscess, omphalitis, umbilical hernia and ileus) and hospital charges."
The authors listed and defined the variables for which data were sought.
[Yes]

P12
"We used a star scoring system [12] based on criteria related to study design, comparability of patient groups, and outcome assessment to assess literature quality. The total score was 9 stars, and the quality of each study was graded as level 1 (0–5 stars) or level 2 (6–9 stars)."
The authors described the methods used for assessing risk of bias of individual studies.
[Yes]

P13
No relevant quotes found.
The authors did not state the principal summary measures.
[No]

P14
No relevant quotes found.
The authors did not perform a meta-analysis.
[NA]

P15
No relevant quotes found.
The authors did not perform a meta-analysis.
[NA]

P16
"Thirdly, due to the inclusion of nonrandomized studies, there is an imbalance in the selection bias."
"Seven outcomes were selected for sensitivity analysis (Table 3). The sensitivity analysis included the following: (1) 12 studies with intracorporeal appendectomy [5,15–18,20,21,25–28,30]; (2) 12 studies with quality score ≥ 6 [5,15–17,20–23,25,26,28,30]; (3) 10 studies with ≥ 30 cases per group [5,15,19,20,22,23,26,27,29,30]. Outcomes that could not be analyzed because of insufficient data (< 2 studies) were excluded from analysis."
The authors described the methods of additional sensitivity analyses.
[Yes]

P17
"377 Publications identified by computerized search: last search done on 20 July 2012 289 Excluded by abstract review 88 Articles screened in complete form 61 Excluded for non comparative studies 27 Comparative studies 10 Excluded for: 2 included secondary appendicitis 5 compared laparoscopic with open appendicectomy 2 no interested data was provided 1 duplicate publication [14] 17 studies included in final meta-analyses: 1 Randomized controlled trial 16 Retrospective studies"
The authors provided a flow diagram with the numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
[Yes]

P18
"The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1."
The authors presented the characteristics of the included studies in Table 1.
[Yes]

P19
"Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29]."
The authors presented data on the risk of bias of each study in Table 2.
[Yes]

P20
The authors presented the results for each individual study in the forest plots in Figures 2-5.
[Yes]

P21
The authors did not perform a meta-analysis.
[NA]

P22
The authors did not perform a meta-analysis.
[NA]

P23
"Seven outcomes were selected for sensitivity analysis (Table 3). The sensitivity analysis included the following: (1) 12 studies with intracorporeal appendectomy [5,15–18,20,21,25–28,30]; (2) 12 studies with quality score ≥ 6 [5,15–17,20–23,25,26,28,30]; (3) 10 studies with ≥ 30 cases per group [5,15,19,20,22,23,26,27,29,30]. Outcomes that could not be analyzed because of insufficient data (< 2 studies) were excluded from analysis."
The authors reported the results of the additional sensitivity analyses.
[Yes]

P24
"Single-incision laparoscopic surgery is developing rapidly in the surgical field, with increasing numbers of surgeons focusing on this technique [23]. Single-incision laparoscopic appendicectomy has been conducted widely in the past few years, it can reduce the trauma of surgical access, and may have cosmetic benefit of conceal the surgical scar within the umbilicus [9,28]."
The authors summarized the main findings and their relevance to key groups.
[Yes]

P25
"We have identified some limitations of this meta-analysis. Firstly, the differences in the age of included patients, pathological type of appendicitis and instruments of SILS may affect the comparability of the included studies. Secondly, different studies may have had different defining criteria for the outcomes we were interested in, which may not be reported in the study methodology. In order to account for this heterogeneity, we have performed sensitivity analysis. Thirdly, due to the inclusion of nonrandomized studies, there is an imbalance in the selection bias."
The authors discussed the limitations at the study and review level.
[Yes]

P26
"In order to investigate the safety and efficacy of SILA in the treatment of appendicitis, more well-designed, multicenter, prospective randomized controlled trials are expected to be published to allow for a more convincing evaluation."
The authors provided a general interpretation of the results in the context of other evidence and implications for future research.
[Yes]

P27
"This study was supported by Science and Technology Fund of Guizhou Province. Grant Number: 黔科合J字 [2008]2181."
The authors described the sources of funding for the systematic review.
[Yes]

85. Dingemann 2014: Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?

LLM response

22 quote(s) from publication full text (mean similarity 98.2%)

A1. Was an 'a priori' design provided?
Quotes: None relevant
Reasoning: The authors do not mention a protocol, ethics approval, or a priori objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "All other manuscripts (e.g., feasibility studies, case reports without control group) were excluded. Manuscripts including an MA were individually analyzed as far as they met our inclusion criteria. End points of our analysis were advantages and disadvantages of VATS procedures compared with the open operation."
Reasoning: The authors mention analyzing manuscripts but do not specify that at least two people independently selected studies and extracted data.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "The Web site was last accessed on January 2, 2013." "The search limits "humans," "child: 0–18 years," "english," "randomized-controlled trials," "comparative study," "systematic reviews," and "meta-analysis" were applied. Abstracts were individually reviewed and only those studies comparing the results and clinical outcome of VATS procedures with the corresponding open operation were chosen for further analysis."
Reasoning: The authors searched PubMed and applied relevant search limits, but did not report searching additional databases or other sources.
[No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant
Reasoning: The authors do not mention including or excluding studies based on publication status or searching for grey literature.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: None relevant 
Reasoning: The authors do not provide a list of included and excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: See Table 3 which provides details on the included studies.
Reasoning: The authors provide an aggregated table with characteristics of the included studies.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "An SR and classification of the methodological quality of studies can be classified as Level 1 or Level 2 according to the CEBM criteria. Contrasting to the great enthusiasm about both pediatric VATS procedures and the principles of evidence-based medicine, the best available evidence derives from RCS that can be classified as CEBM Level 3 at best."
Reasoning: The authors classified studies according to CEBM levels of evidence, which is a method of assessing study quality.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "Except from one preliminary study and a most recently published pilot study, only RCS on pediatric VATS are available for five different types of procedures. Therefore, the best available evidence according to the CEBM criteria is Level 3."
Reasoning: The authors appropriately consider the limited quality of evidence (mostly Level 3) when formulating their conclusions.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "A total of 3 meta-analysis (MA) and 18 retrospective comparative studies (RCS) investigating 5 different VATS procedures (repair of congenital diaphragmatic hernia [CDH], repair of esophageal atresia/tracheoesophageal fistula (EA/TEF), lung resection, treatment of pneumothorax, and resection of neuroblastoma) were included in this study."
Reasoning: The authors included meta-analyses but did not assess heterogeneity or the appropriateness of combining studies, as they did not conduct their own quantitative synthesis.
[NA]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant
Reasoning: The authors did not assess publication bias.
[NA]

A11. Was the conflict of interest included?
Quotes: "Conflict of Interest: None."
Reasoning: The authors report no conflicts of interest for their review, but do not report the funding sources of the included studies.
[No]

P1. Title
Quotes: "Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
Quotes: See the structured abstract with labeled sections for background, materials and methods, results, and conclusion.
Reasoning: The article provides a structured abstract with the required sections.
[Yes]

P3. Introduction / Rationale
Quotes: "The use of video-assisted thoracoscopic surgery (VATS) has evolved quickly and it has gained widespread acceptance among pediatric surgeons during the last decade."
Reasoning: The authors describe the rationale for the review in the context of the increasing use of VATS in pediatric surgery.
[Yes]

P4. Introduction / Objectives
Quotes: "According to a recent classification of the Oxford Centre for Evidence-Based Medicine (CEBM), studies can be classified into Levels 1 to 5 in order of descending quality. We aimed to identify comparative studies investigating VATS versus open procedures in pediatric surgery and to classify publications according to the CEBM criteria."
Reasoning: The authors state their objectives of identifying comparative studies of VATS vs open surgery and classifying them by CEBM evidence levels.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant
Reasoning: The authors do not mention a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quotes: "Only studies published in English, comparing pediatric VATS with the corresponding open operation were included. End points were advantages and disadvantages of VATS as compared with the open procedure. Levels of evidence were determined using the recent CEBM criteria."
Reasoning: The authors specify the inclusion criteria related to PICOS and study characteristics.
[Yes]

P7. Methods / Information sources
Quotes: "Clinical studies published in the English literature were identified by a Medline literature search using PubMed (www.pubmed.com). The Web site was last accessed on January 2, 2013."
Reasoning: The authors describe searching PubMed up to a specified date.
[Yes]

P8. Methods / Search
Quotes: "The search limits "humans," "child: 0–18 years," "english," "randomized-controlled trials," "comparative study," "systematic reviews," and "meta-analysis" were applied."
Reasoning: The authors provide the search limits used but not the full search strategy.
[No]

P9. Methods / Study selection
Quotes: "Abstracts were individually reviewed and only those studies comparing the results and clinical outcome of VATS procedures with the corresponding open operation were chosen for further analysis. All other manuscripts (e.g., feasibility studies, case reports without control group) were excluded. Manuscripts including an MA were individually analyzed as far as they met our inclusion criteria."
Reasoning: The authors state the process for selecting studies based on reviewing abstracts and full texts.
[Yes]

P10. Methods / Data collection process
Quotes: None relevant
Reasoning: The authors do not describe the method of data extraction.
[No]

P11. Methods / Data items
Quotes: None relevant
Reasoning: The authors do not specify all the variables for which data were sought.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: "An SR and classification of the methodological quality of studies can be classified as Level 1 or Level 2 according to the CEBM criteria. Contrasting to the great enthusiasm about both pediatric VATS procedures and the principles of evidence-based medicine, the best available evidence derives from RCS that can be classified as CEBM Level 3 at best."
Reasoning: The authors assessed study quality using CEBM levels of evidence.
[Yes]

P13. Methods / Summary measures
Quotes: None relevant
Reasoning: The authors do not state the principal summary measures.
[No]

P14. Methods / Synthesis of results
Quotes: None relevant
Reasoning: The authors included meta-analyses but did not conduct their own quantitative synthesis.
[NA]

P15. Methods / Risk of bias across studies
Quotes: None relevant
Reasoning: The authors did not assess risk of bias across studies.
[NA]

P16. Methods / Additional analyses
Quotes: None relevant
Reasoning: The authors did not conduct any additional analyses.
[NA]

P17. Results / Study selection
Quotes: "A total of 21 manuscripts met the inclusion criteria of our systematic review of which 3 were MA and 18 were RCS. No studies meeting the requirements for CEBM Level 1 or Level 2 were identified."
Reasoning: The authors report the number of included studies and reasons for exclusions, but do not provide a flow diagram.
[No]

P18. Results / Study characteristics
Quotes: See Table 3 which provides details on the included studies.
Reasoning: The authors provide a table with characteristics of each included study.
[Yes]

P19. Results / Risk of bias within studies
Quotes: "Three MA providing evidence of CEBM Level 3a were identified for three types of VATS procedures (repair of congenital diaphragmatic hernia [CDH], repair of esophageal atresia/tracheoesophageal fistula [EA/TEF], lung resection)."
Reasoning: The authors report the CEBM levels of evidence for each included study type.
[Yes]

P20. Results / Results of individual studies
Quotes: See Table 3 which provides results data for each included study.
Reasoning: The authors provide results for each individual study in a table.
[Yes]

P21. Results / Synthesis of results
Quotes: None relevant
Reasoning: The authors included meta-analyses but did not conduct their own quantitative synthesis.
[NA]

P22. Results / Risk of bias across studies
Quotes: None relevant
Reasoning: The authors did not assess risk of bias across studies.
[NA]

P23. Results / Additional analysis
Quotes: None relevant
Reasoning: The authors did not conduct any additional analyses.
[NA]

P24. Discussion / Summary of evidence
Quotes: "Except from one preliminary study and a most recently published pilot study, only RCS on pediatric VATS are available for five different types of procedures. Therefore, the best available evidence according to the CEBM criteria is Level 3."
Reasoning: The authors summarize the main findings on the limited strength of evidence.
[Yes]

P25. Discussion / Limitations
Quotes: "Irrespective of the medical subspecialty, the employment of evidence-based medicine whenever possible is regarded as the most effective vehicle to achieve more efficient care. Evidence-based medicine is defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients."
Reasoning: The authors discuss limitations related to the lack of high-quality evidence but do not explicitly discuss limitations at the review level.
[No]

P26. Discussion / Conclusions
Quotes: "Except from one preliminary study and a most recently published pilot study, only RCS on pediatric VATS are available for five different types of procedures. Therefore, the best available evidence according to the CEBM criteria is Level 3. Larger randomized controlled trials comparing VATS and the corresponding open procedure are mandatory to obtain the highest possible evidence."
Reasoning: The authors provide general conclusions in the context of the limited available evidence and need for further research.
[Yes]

P27. Funding
Quotes: None relevant
Reasoning: The authors do not report sources of funding for the systematic review.
[No]

86. Dingemann 2013: Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?

LLM response

17 quote(s) from publication full text (mean similarity 100%)

1 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1
"The aim of our study was to evaluate the availability of Level 1 studies comparing laparoscopic procedures with the corresponding open operation in pediatric surgery."
The aim of the study is stated, implying an a priori design.
[Yes]

A2
No mention of duplicate study selection and data extraction.
[No]

A3
"The Web site was last accessed on May 5, 2012. The search limits "humans," "children: 0 to 18 years," "English," "RCTs," "SRs," and "MA" were applied. Abstracts were individually reviewed and only those of studies comparing the results and clinical outcome of laparoscopic procedures with the corresponding open operation were chosen for further analysis."
A comprehensive literature search was performed using PubMed and additional sources.
[Yes]

A4
No mention of including grey literature.
[No]

A5
"A total of 20 manuscripts met the inclusion criteria for our SR, of which 9 were SRs or MAs and 11 RCTs."
A list of included studies is provided in Table 3, but no list of excluded studies is given.
[No]

A6
"For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations."
Key characteristics of included studies are provided in Table 3.
[Yes]

A7
"MA and RCT were identified and individually reviewed. Only studies comparing pediatric laparoscopic procedures with the corresponding open operation were included. RCTs included in MA were only individually analyzed if they focused on additional endpoints."
The scientific quality of included studies was assessed.
[Yes]

A8
"Studies meeting the CEBM criteria for Level 1 are available for only seven laparoscopic pediatric surgical procedures. Effort has to be made to extend the existing Level 1 evidence and to gain high level evidence for further laparoscopic procedures."
The results of the quality assessment were considered in the conclusions.
[Yes]

A9
"MA and RCT were identified and individually reviewed. Only studies comparing pediatric laparoscopic procedures with the corresponding open operation were included."
Meta-analyses were included but methods for combining studies were not described as no quantitative synthesis was performed.
[NA]

A10
No assessment of publication bias.
[NA]

A11
"None"
No conflict of interest statement is provided.
[No]

P1
"Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?"
The title identifies the article as a systematic review.
[Yes]  

P2
The abstract is structured with labeled sections for background, materials and methods, results, and conclusion. However, some key elements like eligibility criteria, appraisal methods, and registration number are missing.
[No]

P3
"The use of laparoscopic techniques has evolved quickly and gained enormous acceptance in pediatric surgery in the last decade."
The rationale for the review is described in the context of the rapid adoption of laparoscopy in pediatric surgery.
[Yes]

P4
"The aim of our study was to evaluate the availability of Level 1 studies comparing laparoscopic procedures with the corresponding open operation in pediatric surgery."
The aim is stated but without explicit reference to PICOS.
[No]

P5
No mention of a review protocol or registration.
[No]

P6
"MA and RCT were identified and individually reviewed. Only studies comparing pediatric laparoscopic procedures with the corresponding open operation were included."
Eligibility criteria are partially described but without full details on PICOS and rationale.
[No]  

P7
"The Web site was last accessed on May 5, 2012."
Information sources are described with date of last search.
[Yes]

P8
No search strategy provided.
[No]

P9
"Abstracts were individually reviewed and only those of studies comparing the results and clinical outcome of laparoscopic procedures with the corresponding open operation were chosen for further analysis."
The study selection process is described.
[Yes]

P10
No description of the data collection process.
[No]

P11
No list of data items is provided.
[No]

P12
"MA and RCT were identified and individually reviewed. Only studies comparing pediatric laparoscopic procedures with the corresponding open operation were included."
Risk of bias assessment is mentioned but methods are not fully described.
[No]

P13
No summary measures are stated.
[No]  

P14
No description of methods for combining results.
[NA]

P15
No assessment of risk of bias across studies.
[NA]

P16
No additional analyses performed.
[NA]

P17
"A total of 20 manuscripts met the inclusion criteria for our SR, of which 9 were SRs or MAs and 11 RCTs."
Numbers of included studies are provided but without a flow diagram or reasons for exclusions.
[No]

P18
Characteristics of included studies are presented in Table 3 with citations.
[Yes]

P19
No presentation of risk of bias for individual studies.
[No]

P20
No results provided for individual studies.
[No]

P21
No meta-analysis performed.
[NA]

P22 
No assessment of risk of bias across studies.
[NA]

P23
No additional analyses performed.
[NA]

P24
"Studies meeting the CEBM criteria for Level 1 are available for only seven laparoscopic pediatric surgical procedures. Effort has to be made to extend the existing Level 1 evidence and to gain high level evidence for further laparoscopic procedures."
The main findings are summarized.
[Yes]

P25
"Nevertheless, the authors strongly believe that we as pediatric surgeons must aim at offering our young patients the best possible treatment. According to the CEBM criteria, achieving this aim requires studies of the highest possible level of evidence. It is therefore essential to make every conceivable effort to obtain Level 1 evidence for further laparoscopic procedures in pediatric surgery and to answer as many open questions as possible for the seven above-mentioned laparoscopic procedures for which Level 1 evidence is already available."
Limitations are discussed in terms of the need for more high-level evidence.
[Yes]

P26
"In the meantime, surgeons have developed new techniques to further decrease the trauma of the operation and improve the postoperative cosmetic appearance for the patient. These innovations range from decreasing the size of the ports and instruments to the current group of techniques termed "scarless" surgery."
A general interpretation is provided in the context of further research on minimally invasive techniques.
[Yes]

P27
"None"
No funding sources are reported.
[No]

87. Ells 2015: Surgery for the treatment of obesity in children and adolescents

LLM response

29 quote(s) from publication full text (mean similarity 97.2%)

A1 - A priori design
Quotes:
"The first version of this systematic review was published in 2003 (Summerbell 2003), and included analysis of childhood obesity treatment studies published up until July 2001. The second version was published in 2009 providing an update to the 2003 review (Oude Luttikhuis 2009)."
"To reflect the rapid growth in this field, the third update to this review has been split across six reviews focusing on the following treatment approaches: surgery; drugs; parent only interventions; diet, physical activity and behavioural interventions for young children aged 0 to 4 years; school children aged 5 to 11 years; and adolescents aged 12 to 17 years."
Reasoning: The review is an update of previous reviews with a pre-specified focus.
[Yes]

A2 - Duplicate study selection and data extraction
Quotes:
"Two review authors independently assessed risk of bias and extracted data. Where necessary authors were contacted for additional information."
Reasoning: Two reviewers independently performed study selection and data extraction.
[Yes]

A3 - Comprehensive literature search
Quotes:
"We searched the Cochrane Library, MEDLINE, PubMed, EMBASE as well as LILACS, ICTRP Search Portal and ClinicalTrials.gov (all from database inception to March 2015). References of identified studies and systematic reviews were checked. No language restrictions were applied."
Reasoning: Multiple databases and trial registries were searched, and references of included studies were checked.
[Yes]

A4 - Grey literature
Quotes:
"We searched the Cochrane Library, MEDLINE, PubMed, EMBASE as well as LILACS, ICTRP Search Portal and ClinicalTrials.gov (all from database inception to March 2015)."
Reasoning: Trial registries were searched, which include grey literature.
[Yes]

A5 - List of included and excluded studies
Quotes:
"We included one RCT (a total of 50 participants, 25 in both the intervention and comparator group)."
"Six studies had to be excluded after careful evaluation of the full publication (Aikenhead 2011; Black 2013; Farina 2012; Gloy 2013; Picot 2009; Tyvonchuk 2009; see Figure 1)."
Reasoning: The included study is described, and excluded studies with reasons are listed and shown in a flow diagram.
[Yes]

A6 - Characteristics of included studies
Quotes:
"A detailed description of the characteristics of included studies is presented elsewhere (see Characteristics of included studies and appendices). The following is a succinct overview:"
Reasoning: The characteristics of the included study are reported in a table.
[Yes]

A7 - Scientific quality assessment
Quotes:
"Two review authors independently assessed risk of bias and extracted data."
"We planned to assess risk of bias using the Cochrane risk of bias tool (Higgins 2011a; Higgins 2011b). We applied the following criteria."
Reasoning: Risk of bias was independently assessed using the Cochrane risk of bias tool.
[Yes]

A8 - Scientific quality used in formulation of conclusions
Quotes:
"Our results are limited to two years of follow-up and are based on just one small Australian study with some risk of bias which was conducted in a private hospital, receiving funding from the gastric banding manufacturer. There is currently insufficient evidence to make an informed judgement about efficacy."
Reasoning: The limitations of the included study, including risk of bias, are considered when drawing conclusions.
[Yes]

A9 - Methods to combine findings
No relevant quotes found.
Reasoning: This is a systematic review without a meta-analysis, so methods for combining study findings are not applicable.
[NA]

A10 - Publication bias assessment
No relevant quotes found.
Reasoning: This is a systematic review without a meta-analysis, so assessment of publication bias is not applicable.
[NA] 

A11 - Conflict of interest stated
Quotes:
"We would like to thank Leanne Mohan (Teesside University) and Gudrun Paletta (Cochrane Metabolic and Endocrine Disorders Group) for helping with review management."
Reasoning: Sources of support for the systematic review are acknowledged, but not for the included study.
[No]

P1 - Title
Quote: "Surgery for the treatment of obesity in children and adolescents"
Reasoning: The title identifies the report as a systematic review.
[Yes]

P2 - Structured abstract
Quote: The abstract contains labeled Background, Objectives, Search methods, Selection criteria, Data collection and analysis, Main results sections.
Reasoning: The abstract is structured with the required sections.
[Yes]

P3 - Rationale
Quote: "Child and adolescent overweight and obesity have increased globally, and are associated with significant short and long term health consequences."
Reasoning: The rationale for the review is described in the context of the increasing prevalence and consequences of child/adolescent obesity.
[Yes]

P4 - Objectives
Quote: "To assess the effects of surgical interventions for treating obesity in childhood and adolescence."
Reasoning: An explicit objective is provided.
[Yes]

P5 - Protocol and registration
Quote: "The first version of this systematic review was published in 2003 (Summerbell 2003), and included analysis of childhood obesity treatment studies published up until July 2001. The second version was published in 2009 providing an update to the 2003 review (Oude Luttikhuis 2009)."
Reasoning: Previous versions of the review are referenced, but no protocol or registration number is provided.
[No]

P6 - Eligibility criteria
Quote: "We selected randomised controlled trials (RCTs) of surgical interventions for treating obesity in children and adolescents (age < 18 years) with a minimum of six months follow-up. Interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity were excluded."
Reasoning: The eligibility criteria for study design, participants, interventions, and follow-up are specified.
[Yes]

P7 - Information sources
Quote: "We searched the Cochrane Library, MEDLINE, PubMed, EMBASE as well as LILACS, ICTRP Search Portal and ClinicalTrials.gov (all from database inception to March 2015). References of identified studies and systematic reviews were checked."
Reasoning: The information sources searched are described, including the dates of coverage.
[Yes]

P8 - Search
No relevant quotes found.
Reasoning: The full search strategy is not presented for any of the databases.
[No]

P9 - Study selection
Quote: "Two review authors independently assessed risk of bias and extracted data."
Reasoning: The process of study selection by two independent reviewers is stated.
[Yes]

P10 - Data collection process
Quote: "Two review authors independently assessed risk of bias and extracted data. Where necessary authors were contacted for additional information."
Reasoning: Data extraction was done independently by two reviewers, and study authors were contacted for more information when needed.
[Yes]

P11 - Data items
Quote: "We defined the following outcomes as self-reported outcomes. • BMI and weight loss, if measured by participants. • Adverse events, if reported by participants. • Health-related quality of life and self esteem. • Participants views of the intervention. • Behaviour change."
Reasoning: The outcomes for which data were sought are defined.
[Yes]

P12 - Risk of bias in individual studies
Quote: "We planned to assess risk of bias using the Cochrane risk of bias tool (Higgins 2011a; Higgins 2011b). We applied the following criteria."
Reasoning: The Cochrane risk of bias tool was used to assess included studies.
[Yes]

P13 - Summary measures
No relevant quotes found.
Reasoning: No summary measures are specified as no meta-analysis was conducted.
[NA]

P14 - Synthesis of results
No relevant quotes found.
Reasoning: No meta-analysis was performed so methods of combining results are not applicable.
[NA]

P15 - Risk of bias across studies
No relevant quotes found.
Reasoning: Methods for assessing risk of bias across studies are not mentioned as no meta-analysis was performed.
[NA]

P16 - Additional analyses
Quote: "We planned to carry out the following subgroup analyses and wanted to investigate interaction. • Length of follow-up. • Impact and nature of maintenance periods. • The impact of comparator or control: whether concomitant therapy or no treatment (true control). • The impact of population demographics."
Reasoning: Planned subgroup analyses are described.
[Yes]

P17 - Study selection
Quote: See Figure 1 study flow diagram.
Reasoning: The flow diagram provides the numbers of studies screened, assessed for eligibility, included and excluded with reasons at each stage.
[Yes]

P18 - Study characteristics
Quote: "A detailed description of the characteristics of included studies is presented elsewhere (see Characteristics of included studies and appendices). The following is a succinct overview:"
Reasoning: Characteristics of the included study are provided.
[Yes]

P19 - Risk of bias within studies
Quote: See Figure 2 risk of bias summary.
Reasoning: A risk of bias summary figure is presented showing judgements for each bias domain for the included study.
[Yes]

P20 - Results of individual studies
Quote: "We included one RCT (a total of 50 participants, 25 in both the intervention and comparator group). The intervention focused on laparoscopic adjustable gastric banding surgery, which was compared to a control group receiving a multi component lifestyle programme. The participating population consisted of Australian adolescents aged 14 to 18 years, with a mean age of 16.5 and 16.6 years in the gastric banding and lifestyle group, respectively which was conducted in a private hospital, receiving funding from the gastric banding manufacturer. The study authors were unable to blind participants, personnel and outcome assessors which may have resulted in a high risk of performance and detection bias. At 24 months follow-up, the mean change in BMI units was 12.7 (95% CI 11.3 to 14.2) for the surgery group compared to 1.3 (95% CI 0.4 to 2.9) for the lifestyle intervention."
Reasoning: Results are provided for the included study, including effect estimates and confidence intervals.
[Yes]

P21 - Synthesis of results
No relevant quotes found.
Reasoning: No meta-analysis was performed so results of each meta-analysis are not applicable.
[NA]

P22 - Risk of bias across studies
No relevant quotes found.
Reasoning: No assessment of risk of bias across studies is reported as no meta-analysis was done.
[NA]

P23 - Additional analyses
No relevant quotes found.
Reasoning: The results of additional analyses are not provided.
[No]

P24 - Summary of evidence
Quote: "This review reports the findings from one RCT (50 participants). The intervention focused on laparoscopic adjustable gastric banding surgery, which was compared to a control group receiving a multi component lifestyle program. The study authors were unable to blind their participants, personnel and outcome assessors which may have resulted in a high risk of performance and detection bias. At 24 months follow-up, the mean change in BMI units was 12.7 (95% CI 11.3 to 14.2) for the surgery group compared to 1.3 (95% CI 0.4 to 2.9) for the control group. Adverse events were reported in 12/25 participants in the intervention group compared to 11/25 in the control group."
Reasoning: The main findings are summarized including the strength of evidence for the main outcomes.
[Yes]

P25 - Limitations
Quote: "Our results are limited to two years of follow-up and are based on just one small Australian study with some risk of bias which was conducted in a private hospital, receiving funding from the gastric banding manufacturer. There is currently insufficient evidence to make an informed judgement about surgery for the treatment of obesity in children and adolescents."
Reasoning: Limitations at the study level (risk of bias, follow-up duration, funding source) and review level (only one small study) are discussed.
[Yes]

P26 - Conclusions
Quote: "Whilst an encouraging finding in terms of weight loss, there are several reasons to be cautious about these findings and more data are required, including data on whether this weight loss is maintained over the longer term. In addition, the financial burden of this type of surgery is high and the approach is not without risk. Long-term follow-up is also critical to comprehensively assess the impact of surgery as participants enter adulthood."
Reasoning: A general interpretation is provided in the context of the limitations and need for more evidence.
[Yes]

P27 - Funding
Quote: "We would like to thank Leanne Mohan (Teesside University) and Gudrun Paletta (Cochrane Metabolic and Endocrine Disorders Group) for helping with review management."
Reasoning: Sources of funding and other support for the systematic review are described.
[Yes]

88. Elyas 2010: Is Staging Beneficial for Fowler-Stephens Orchiopexy? A Systematic Review

LLM response

24 quote(s) from publication full text (mean similarity 93.9%)

A1. Was an 'a priori' design provided?
Quote: "We conducted a systematic review to determine whether single or 2-stage Fowler-Stephens orchiopexy results in better testicular viability."
Reasoning: The research question was established before conducting the review.
[Yes]

A2. Was there duplicate study selection and data extraction?
Quote: "Each author was allocated roughly 10 articles, and independently abstracted the data and assessed the quality of the reports. Noncomparative case series were evaluated using a quality assessment instrument developed for this study."
Reasoning: Data extraction was done independently by each author.
[Yes]

A3. Was a comprehensive literature search performed?
Quotes: "We searched electronic databases, clinical trial registries and gray literature. We included reports describing boys younger than 18 years with a primary outcome of "testicular viability and position." We performed a meta-analysis using random effects models."
Reasoning: Multiple electronic databases and supplementary sources were searched.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quote: "We searched electronic databases, clinical trial registries and gray literature."
Reasoning: A search for gray literature was performed.
[Yes]

A5. Was a list of studies (included and excluded) provided?
Quote: "After a thorough assessment 99 articles underwent a full review for evaluation of quality and an additional 13 studies from the gray literature search."
Reasoning: The number of included and excluded studies was provided but not a full reference list.
[No]

A6. Were the characteristics of the included studies provided?
Quote: "The table summarizes the quality assessment results of the included articles."
Reasoning: A table summarizing key characteristics of included studies was provided.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: "A calibration exercise was conducted to clarify any discordance. Each article was evaluated by 2 of us independently and any disagreement was resolved by consensus with the help of a third reviewer."
Reasoning: The quality of included studies was independently assessed.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "Although the rate of testicular survival is high, the level of evidence of the studies was low, and a study of a more robust design, such as a randomized controlled trial, should be performed to evaluate and compare the efficacies of these therapies in the pediatric population."
Reasoning: The limitations of the low quality evidence were considered when drawing conclusions.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quote: "The effectiveness of single stage vs 2-stage Fowler-Stephens orchiopexy was evaluated based on testicular viability (size and location) following the procedure. Meta-analysis using weighted mean difference (random effects model) was conducted using R software (R Foundation for Statistical Computing, Wien, Austria)."
Reasoning: Appropriate meta-analytic methods were used to combine study findings.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant.
Reasoning: No assessment of publication bias was reported, likely because there were fewer than 10 studies.
[No]

A11. Was the conflict of interest included?
Quotes: None relevant.
Reasoning: Sources of support for the review and included studies were not reported.
[No]

P1. Title
Quote: "Is Staging Beneficial for Fowler-Stephens Orchiopexy? A Systematic Review"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
Quote: See structured abstract on first page.
Reasoning: A structured abstract with labeled sections is provided.
[Yes]

P3. Introduction / Rationale
Quote: "Fowler and Stephens showed that by dividing the spermatic vessels a high intra-abdominal testis could be brought into the scrotum. This maneuver carries a potential complication of this technique."
Reasoning: The rationale for the review is provided in the context of what is known.
[Yes]

P4. Introduction / Objectives
Quote: "We conducted a systematic review to determine whether single or 2-stage Fowler-Stephens orchiopexy results in better testicular viability."
Reasoning: An explicit statement of the review question is provided.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quote: "Studies were considered relevant if they met the following inclusion criteria. Patients were younger than 18 years, had an intra-abdominal testis, had undergone single or 2-stage FSO (open or laparoscopic), and had data regarding testicular position and postoperative intraoperatively. RCTs and noncomparative case series were evaluated."
Reasoning: Study eligibility criteria are specified.
[Yes]

P7. Methods / Information sources
Quote: "We searched several electronic databases, including MEDLINE®, EMBASE®, CINAHL®, Cochrane Central Register of Control Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and ACP Journal Club®. This search was restricted to articles published in English and was dated to February 2009."
Reasoning: Information sources searched are described.
[Yes]

P8. Methods / Search
Quotes: None relevant.
Reasoning: The full search strategy is not presented.
[No]

P9. Methods / Study selection
Quote: "After a thorough assessment 99 articles underwent a full review for evaluation of quality and an additional 13 studies from the gray literature search."
Reasoning: The study selection process is described.
[Yes]

P10. Methods / Data collection process
Quote: "Each author was allocated roughly 10 articles, and independently abstracted the data and assessed the quality of the reports."
Reasoning: The data extraction process is described.
[Yes]

P11. Methods / Data items
Quotes: None relevant.
Reasoning: Data items collected are not explicitly defined.
[No]

P12. Methods / Risk of bias in individual studies
Quote: "A calibration exercise was conducted to clarify any discordance. Each article was evaluated by 2 of us independently and any disagreement was resolved by consensus with the help of a third reviewer."
Reasoning: Risk of bias assessment for individual studies is described.
[Yes]

P13. Methods / Summary measures
Quote: "The effectiveness of single stage vs 2-stage FSO was evaluated based on testicular viability (size and location) following the procedure."
Reasoning: The main outcome measure is stated.
[Yes]

P14. Methods / Synthesis of results
Quote: "Meta-analysis using weighted mean difference (random effects model) was conducted using R software (R Foundation for Statistical Computing, Wien, Austria)."
Reasoning: The meta-analysis methods are described.
[Yes]

P15. Methods / Risk of bias across studies
Quotes: None relevant.
Reasoning: Methods for assessing risk of bias across studies are not mentioned.
[No]

P16. Methods / Additional analyses
Quotes: None relevant.
Reasoning: No additional analyses are mentioned.
[NA]

P17. Results / Study selection
Quote: "A total of 1,807 potentially relevant articles were retrieved from the initial electronic database search and an additional 13 studies from the gray literature search. After a thorough assessment 99 articles underwent a full review for evaluation of quality and an additional 13 studies from the gray literature search."
Reasoning: The number of studies at each stage of selection is provided.
[Yes]

P18. Results / Study characteristics
Quote: See table on page 2014.
Reasoning: Characteristics of included studies are provided in a table.
[Yes]

P19. Results / Risk of bias within studies
Quotes: None relevant.
Reasoning: Results of the risk of bias assessment for each study are not presented.
[No]

P20. Results / Results of individual studies
Quote: See forest plots in Figures 2-4 and 6-8.
Reasoning: Forest plots show the results of individual studies.
[Yes]

P21. Results / Synthesis of results
Quote: "The pooled estimate of success rates was 80% for single stage FSO (95% CI 75 to 86) and the I2 was 11% (fig. 2). Among 36 articles (751 testes) including success rates of 2-stage FSO the pooled estimate of success rate was 85% (95% CI 81 to 90) and the I2 was 43% (fig. 3)."
Reasoning: Meta-analysis results with confidence intervals and heterogeneity are reported.
[Yes]

P22. Results / Risk of bias across studies
Quotes: None relevant.
Reasoning: Results of across-study bias assessment are not reported.
[NA]

P23. Results / Additional analysis
Quotes: None relevant.
Reasoning: No additional analyses were mentioned in methods.
[NA]

P24. Discussion / Summary of evidence
Quote: "Based on the results of this review, both approaches have a fairly high success rate, although 2-stage FSO appears to carry a higher rate of success over the single stage procedure, defined as postoperative viability of the testis (95% vs 80%, OR 2 in favor of 2-stage)."
Reasoning: The main findings are summarized.
[Yes]

P25. Discussion / Limitations
Quote: "Although the rate of testicular survival is high, the level of evidence of the studies was low, and a study of a more robust design, such as a randomized controlled trial, should be performed to evaluate and compare the efficacies of these therapies in the pediatric population."
Reasoning: Limitations of the evidence are discussed.
[Yes]

P26. Discussion / Conclusions
Quote: "Based on the results of this review, both approaches have a fairly high success rate, although 2-stage FSO appears to carry a higher rate of success over the single stage procedure, defined as postoperative viability of the testis (95% vs 80%, OR 2 in favor of 2-stage)."
Reasoning: Conclusions are provided in the context of the evidence.
[Yes]

P27. Funding
Quotes: None relevant.
Reasoning: Sources of funding for the review are not reported.
[No]

89. Esposito 2014: Laparoscopic Versus Open Inguinal Hernia Repair in Pediatric Patients: A Systematic Review

LLM response

21 quote(s) from publication full text (mean similarity 93.5%)

A1. Was an 'a priori' design provided?
Quote: "Eligibility criteria for all studies published during the last 20 years that described open or laparoscopic operation for inguinal hernia, and the latter was compared with conventional OH."
The eligibility criteria were pre-specified.
[Yes]

A2. Was there duplicate study selection and data extraction?
Quote: "Data regarding the following as limits: clinical trials, randomized controlled trials, multicenter retrospective, prospective studies, and expert opinion."
Data extraction was described, but no mention of duplicate study selection or data extraction.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A literature search was performed on all studies published during the last 20 years, reporting on outcomes of OH and LH, in terms of operative time, recurrence rate and other complications, finding of rare hernias, and incidence of contralateral patency." "Publications were imposed initially, the search was limited to studies published in the English language for the full-text review and final analysis."
At least 2 databases (PubMed, Cochrane, Medline) were searched over a 20 year period. Only English language studies were included.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
The inclusion of grey literature like conference abstracts was not mentioned.
[No]

A5. Was a list of studies (included and excluded) provided?
Quote: "Of the studies analyzed, there were 39 articles that met the inclusion criteria and were selected for the final analysis."
The number of included studies was provided, but no list of excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quote: "Fifty-three studies matched the inclusion criteria and were selected for the final analysis."
Table 1 provides an aggregated summary of the characteristics of included studies.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
The methodological quality of individual studies was not assessed.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Since study quality was not assessed, it could not be incorporated into the conclusions.
[NA]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "A conversion rate was reported in eight studies and ranged between 0% and 1.7%, but in the majority of these studies, there was a 0% conversion rate." "Looking at the averages, there is no significant difference regarding recurrence rate comparing the two techniques (OH, 1.6% [26 recurrences out of 1539 hernia repairs]; LH, 1.4% [138 recurrences out of 9605 hernia repairs]) (P = .66)."
Quantitative synthesis was not performed, but results were described narratively in an appropriate manner, taking study heterogeneity into account.
[Yes]

A10. Was the likelihood of publication bias assessed?
Publication bias was not assessed.
[No]

A11. Was the conflict of interest included?
Conflicts of interest for the systematic review and included studies were not reported.
[No]

P1. Title
Quote: "Laparoscopic Versus Open Inguinal Hernia Repair in Pediatric Patients: A Systematic Review"
The article title identifies the report as a systematic review.
[Yes]

P2. Abstract / Structured summary
The abstract is structured with labeled sections for Aim, Materials and Methods, and Results. However, some key elements like the registration number are missing.
[No]

P3. Introduction / Rationale
Quote: "The incidence of an inguinal hernia in children less than 18 years of age ranges from 0.8% to 4.4%."
Relevant background information is provided to contextualize the review.
[Yes]  

P4. Introduction / Objectives
Quote: "The aim of this review is to analyze the current literature to determine the outcome of LH compared with OH."
The objective is stated, but without explicit reference to PICOS elements.
[No]

P5. Methods / Protocol and registration
A review protocol and registration number were not reported.
[No]

P6. Methods / Eligibility criteria
Quote: "As for operative time, in unilateral inguinal hernia repair, there was no significant difference between LH and OH (P = .33). In contrast, in bilateral disease, LH is faster than OH (P = .01)."
Eligibility criteria related to study characteristics (PICOS) and report characteristics were specified.
[Yes]

P7. Methods / Information sources
Quote: "A literature search was performed using PubMed, Cochrane, and Medline databases on all studies published during the last 20 years that described open or laparoscopic operation for inguinal hernia, and the latter was compared with conventional OH."
Multiple databases were searched, but the date last searched was not provided.
[No]

P8. Methods / Search
The full search strategy was not presented.
[No]

P9. Methods / Study selection
Quote: "Eligibility criteria for all studies published during the last 20 years that described open or laparoscopic operation for inguinal hernia, and the latter was compared with conventional OH."
The process for study selection based on eligibility criteria was described.
[Yes]

P10. Methods / Data collection process
Quote: "Data regarding the following as limits: clinical trials, randomized controlled trials, multicenter retrospective, prospective studies, and expert opinion."
The data collection process was described in general terms.
[Yes]  

P11. Methods / Data items
Quote: "Data regarding the following as limits: clinical trials, randomized controlled trials, multicenter retrospective, prospective studies, and expert opinion."
The types of data collected were described.
[Yes]

P12. Methods / Risk of bias in individual studies
The assessment of risk of bias in individual studies was not described.
[No]

P13. Methods / Summary measures
Summary measures were not explicitly stated.
[No]  

P14. Methods / Synthesis of results
A quantitative synthesis was not performed.
[NA]

P15. Methods / Risk of bias across studies
Assessment of risk of bias across studies, such as publication bias, was not mentioned.
[NA]

P16. Methods / Additional analyses
Additional analyses were not mentioned.
[NA]

P17. Results / Study selection
Quote: "Of the studies analyzed, there were 39 articles that met the inclusion criteria and were selected for the final analysis."
The number of included studies was reported, but without a flow diagram or reasons for exclusions.
[No]

P18. Results / Study characteristics
Quote: "Fifty-three studies matched the inclusion criteria and were selected for the final analysis."
Table 1 presents an aggregated summary of study characteristics.
[Yes]

P19. Results / Risk of bias within studies
Risk of bias assessments for individual studies were not reported.
[No]

P20. Results / Results of individual studies
Simple summary data for each group and effect estimates for each study were not consistently reported.
[No]

P21. Results / Synthesis of results
A quantitative synthesis was not performed.
[NA]

P22. Results / Risk of bias across studies
Assessment of risk of bias across studies was not reported.
[NA]

P23. Results / Additional analysis
No additional analyses were reported.
[NA]

P24. Discussion / Summary of evidence
Quotes: "Laparoscopic inguinal hernia repair in children was first described by Montupet in 1993, as noted by Schier." "An interesting finding in our current review is that the majority of studies published in the last 20 years are focused on the laparoscopic approach."
The main findings were summarized with reference to key groups.
[Yes]

P25. Discussion / Limitations
Quote: "However, the length of follow-up in reviewed series was less for the laparoscopic approach compared with the open operation (2.3 versus 4.2 years, respectively)."
Some limitations at the review level were discussed.
[Yes]

P26. Discussion / Conclusions
Quote: "In summary, LH appears faster for bilateral hernia repair when compared with the inguinal crease approach. Recurrence rates appear similar, but the follow-up is less in the LH studies."
The conclusions provided a general interpretation of the results.
[Yes]

P27. Funding
Sources of funding for the systematic review were not described.
[No]

90. Feng 2016: Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis

LLM response

14 quote(s) from publication full text (mean similarity 100%)

1 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1
Quote: "Literature searches were conducted to identify studies having compared the laparoscopic splenectomy (LS) and open splenectomy (OS) for children."
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
Quotes: "Included studies were independently reviewed by two reviewers, and a third reviewer was required for a final decision in the case of any discrepancies. The primary outcome measures of our analysis was to evaluate the operative time, blood loss, and length of postoperative stay."
Reasoning: Study selection and data extraction were done independently by at least two reviewers.
[Yes]

A3
Quote: "Published records were searched using the MEDLINE, EMBASE, and Web of Science from 1993 to 2015."
Reasoning: At least two electronic databases were searched.
[No] - No supplementary search strategies were mentioned.

A4
Reasoning: The inclusion of grey literature was not specified.
[No]

A5
Reasoning: A list of included and excluded studies was not provided.
[No]

A6
Quote: "In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes."
Reasoning: Table 1 provides the characteristics of the included studies.
[Yes]

A7
Reasoning: The methods for assessing scientific quality or risk of bias of the included studies were not described.
[No]

A8
Reasoning: Not applicable as the scientific quality of included studies was not assessed (A7).
[NA]

A9
Reasoning: Not applicable as this was a systematic review without a meta-analysis.
[NA]

A10
Reasoning: Not applicable as this was a systematic review without a meta-analysis.
[NA]

A11
Reasoning: Potential sources of support or conflicts of interest were not reported for the systematic review or the included studies.
[No]

P1
Quote: "Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis"
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2
Reasoning: The abstract is structured with labeled sections for background, methods, results, and conclusion.
[Yes]

P3
Quote: "Splenectomy is occasionally performed in children with various hematologic disorders such as sickle cell disease, idiopathic thrombocytopenic purpura, and so on [1]. Open splenectomy (OS) has some potential disadvantages such as abdominal wall scarring and the high risk of wound infection [2]."
Reasoning: The introduction describes the rationale for the review in the context of what is already known.
[Yes]

P4
Quote: "The primary outcome measures of our analysis was to evaluate the operative time, blood loss, and length of postoperative stay."
Reasoning: The introduction provides the questions being addressed with reference to outcomes, but not participants, interventions, comparisons or study design.
[No]

P5
Reasoning: The existence of a review protocol was not mentioned.
[No]

P6
Quote: "Inclusion criteria: (1) clinical trials that compared laparoscopic versus open splenectomy between 1993 and 2015; (2) children under 18 years old who suffered from benign or malignant hematological diseases; exclusion criteria: (1) no open splenectomy as a control; (2) reports fewer than ten cases per group; and (3) studies did not provide available original data or duplicate publications."
Reasoning: The methods section specifies the study characteristics and report characteristics used as criteria for eligibility.
[Yes]

P7
Quote: "Published records were searched using the MEDLINE, EMBASE, and Web of Science from 1993 to 2015."
Reasoning: The methods section describes the information sources searched and the date range, but not the date last searched.
[No]

P8
Reasoning: The full electronic search strategy was not presented.
[No]

P9
Quote: "Studies comparing LS and OS in children were included regardless of randomization or non-randomization."
Reasoning: The methods section states the process for selecting studies.
[Yes]

P10
Quote: "Included studies were independently reviewed by two reviewers, and a third reviewer was required for a final decision in the case of any discrepancies."
Reasoning: The methods section describes the data extraction process.
[Yes]

P11
Reasoning: The data items sought were not explicitly defined.
[No]

P12
Reasoning: The methods for assessing risk of bias were not described.
[No]

P13
Reasoning: The principal summary measures were not explicitly stated.
[No]

P14
Reasoning: Not applicable as no meta-analysis was performed.
[NA]

P15
Reasoning: Methods for assessing risk of bias across studies were not specified.
[No]

P16
Reasoning: Not applicable as no additional analyses were reported.
[NA]

P17
Quote: "As shown in Fig. 1 of the workflow, 21 of the 159 publications identified from the initial literature search were retrieved for full text review and 10 studies with 922 participants (508 received LS and 414 OS) met our total inclusion criteria as summarized in Table 1 together with basic demographic data from each included study, including age, male:female sex ratio and spleen size/weight/ volume in each group."
Reasoning: The results section provides the number of studies screened, assessed for eligibility, and included, with reasons for exclusions, in a flow diagram (Fig. 1).
[Yes]

P18
Quote: "As shown in Fig. 1 of the workflow, 21 of the 159 publications identified from the initial literature search were retrieved for full text review and 10 studies with 922 participants (508 received LS and 414 OS) met our total inclusion criteria as summarized in Table 1 together with basic demographic data from each included study, including age, male:female sex ratio and spleen size/weight/ volume in each group."
Reasoning: Table 1 presents the characteristics of each included study.
[Yes]

P19
Reasoning: Results of the risk of bias assessment for each study were not presented.
[No]

P20
Reasoning: Simple summary data for each intervention group in each study were not provided.
[No]

P21
Reasoning: Not applicable as no meta-analysis was performed.
[NA]

P22
Reasoning: Not applicable as no assessment of risk of bias across studies was reported.
[NA]

P23
Reasoning: Not applicable as no additional analyses were reported.
[NA]

P24
Quote: "In conclusion, our study suggests that LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. LS is associated with shorter hospital stays, less blood loss, and longer operative times compared with OS."
Reasoning: The discussion summarizes the main findings.
[Yes]

P25
Quote: "Our systematic review and meta-analysis have several limitations. On one hand, there was no randomized clinical trials available in the literature for our study and the decision to perform LS or OS usually depends on preference and experiences of surgeons. Besides, some of the included studies had rather small sample size."
Reasoning: The discussion addresses limitations at the review level.
[No] - Limitations at the study and outcome level were not discussed.

P26
Quote: "In conclusion, our study suggests that LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. LS is associated with shorter hospital stays, less blood loss, and longer operative times compared with OS. Furthermore, LS has a similar rate of the removal of accessory spleens and postoperative complications including postoperative high fever, ACS, and ileus when compared to OS in children."
Reasoning: The discussion provides a general interpretation of the results in the context of other evidence and implications for practice.
[Yes]

P27
Reasoning: Sources of funding for the systematic review were not described.
[No]

91. Feng 2015: Open Versus Laparoscopic Inguinal Herniotomy in Children

LLM response

29 quote(s) from publication full text (mean similarity 92.2%)

A1. Was an 'a priori' design provided?
Quote: "The aim of this systematic review and meta-analysis was to compare the surgical strategies as regards operative time, recurrence rate, postoperative complications by means of a systematic review, and meta-analysis of the available literatures."
Reasoning: The aim is stated but there is no mention of a protocol, ethics approval, or pre-determined/a priori objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quote: "The first author independently extracted data from the included studies. Details of publication (first author, year, country, the internal ring, trocars, and follow-up duration), inclusion and exclusion criteria, and demographics of the enrolled patients were collected and collated. Quality of the RCTs was assessed, including randomization, method of blinding, and allocation concealment."
Reasoning: Data extraction was done by one author independently, but no mention of duplicate study selection or a consensus procedure.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "We systematically searched PubMed for relevant studies reported from 2005 to 2014 with the keywords "laparoscopic herniorrhaphy", "pediatric inguinal hernia," and "open herniorrhaphy." Total reference lists of selected articles were also included. We limited our searches to the publications written in English."
Reasoning: At least 2 electronic databases (PubMed and reference lists) were searched with keywords. Years were provided but full search strategy was not.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quote: "We limited our searches to the publications written in English."
Reasoning: Only published English studies were included, grey literature was not searched.
[No]

A5. Was a list of studies (included and excluded) provided?
Quote: "Articles excluded because of failure to meet inclusion criteria (n = 235)"
Reasoning: A flow diagram is provided showing numbers excluded at each stage, but not a full list of excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quote: "Details of publication (first author, year, country, the internal ring, trocars, and follow-up duration), inclusion and exclusion criteria, and demographics of the enrolled patients were collected and collated."
Reasoning: Key characteristics of included studies like country, interventions, and follow-up duration were provided in an aggregated table.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: "Quality of the RCTs was assessed, including randomization, method of blinding, and allocation concealment."
Reasoning: The quality of included RCTs was assessed for key items like randomization, blinding, and allocation concealment.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "Despite no significant difference was observed regarding the recurrence, LH can be accepted as a minimally invasive technique for PIH. In our systematic review of high-level evidence, LH was found to be superior to OH with respect to a shorter time for unilateral hernias in extraperitoneal approaches group and for bilateral hernias in both the groups."
Reasoning: The conclusions consider the quality of evidence, stating it is high-level evidence that found LH superior for certain outcomes.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Review Manager (RevMan) software, version 5.3 was used for data statistical analysis. Weighted mean differences and odds ratios were used for continuous and dichotomous variables, respectively. The confidence interval (CI) was established at 95%. Statistical heterogeneity of the meta-analysis was assessed with the χ2 test and the I2 index. If the I2 value was < 50%, then a fixed-effects meta-analysis was applied; if the I2 value was ≥ 50%, then a random-effects approach instead of a fixed-effect analysis would be undertaken."
Reasoning: Appropriate methods were used to combine studies, assessing heterogeneity and using a random effects model if I2 ≥ 50%.
[Yes]

A10. Was the likelihood of publication bias assessed?
Reasoning: There is no mention of assessing publication bias through a funnel plot or statistical test. However, this may not have been possible with the small number of included studies.
[No]

A11. Was the conflict of interest included?
Reasoning: The source of funding for the systematic review is not reported, and sources of support for the included studies are not provided.
[No]

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quote: "Open Versus Laparoscopic Inguinal Herniotomy in Children: A Systematic Review and Meta-Analysis Focusing on Postoperative Complications"
Reasoning: The title clearly identifies this as a systematic review and meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quote: The abstract contains labeled sections for Purpose, Methods, Results, and Conclusions.
Reasoning: The abstract is structured with the key PRISMA-recommended sections.
[Yes]

P3. Introduction / Rationale
Quote: "There is an ongoing debate about whether laparoscopic or open herniorrhaphy (LH or OH) is the best choice for inguinal hernia in children. The aim of this study was to compare both of the surgical strategies as regards operative time, recurrence rate, postoperative complications by means of a systematic review, and meta-analysis of the available literatures."
Reasoning: The rationale for the review is provided in the context of the ongoing debate about laparoscopic vs open herniorrhaphy in children.
[Yes]

P4. Introduction / Objectives
Quote: "The aim of this study was to compare both of the surgical strategies as regards operative time, recurrence rate, postoperative complications by means of a systematic review, and meta-analysis of the available literatures."
Reasoning: The objectives are stated, mentioning the comparison of surgical strategies and the outcomes of interest.
[Yes]

P5. Methods / Protocol and registration
Reasoning: There is no mention of a review protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quote: "Two hundred and seventy-eight patients received OH and 275 received LH. Study details including postoperative complications were pooled for meta-analysis of the available literatures."
Reasoning: Some eligibility criteria can be inferred (studies of OH vs LH reporting postoperative complications) but the full criteria are not explicitly stated.
[No]

P7. Methods / Information sources
Quote: "We systematically searched PubMed for relevant studies reported from 2005 to 2014 with the keywords "laparoscopic herniorrhaphy", "pediatric inguinal hernia," and "open herniorrhaphy." Total reference lists of selected articles were also included. We limited our searches to the publications written in English."
Reasoning: PubMed and reference lists were searched up to 2014.
[Yes]

P8. Methods / Search
Quote: "We systematically searched PubMed for relevant studies reported from 2005 to 2014 with the keywords "laparoscopic herniorrhaphy", "pediatric inguinal hernia," and "open herniorrhaphy.""
Reasoning: The keywords are provided but not the full search strategy for reproducibility.
[No]

P9. Methods / Study selection
Quote: "Our search was restricted to RCTs. Controlled clinical trials and comparative studies (including case-matched studies) were excluded. Eligibility criteria included total available studies comparing LH with OH for the repair of PIH. The children were younger than 18 years when they underwent LH or OH."
Reasoning: The process of screening for RCTs and applying eligibility criteria is described.
[Yes]

P10. Methods / Data collection process
Quote: "The first author independently extracted data from the included studies."
Reasoning: Data extraction was done independently but no mention of using a standardized form or process for obtaining missing data.
[No]

P11. Methods / Data items
Quote: "Details of publication (first author, year, country, the internal ring, trocars, and follow-up duration), inclusion and exclusion criteria, and demographics of the enrolled patients were collected and collated."
Reasoning: The key data items collected are listed.
[Yes]

P12. Methods / Risk of bias in individual studies
Quote: "Quality of the RCTs was assessed, including randomization, method of blinding, and allocation concealment."
Reasoning: Risk of bias was assessed using items like randomization, blinding, and allocation concealment.
[Yes]

P13. Methods / Summary measures
Quote: "Weighted mean differences and odds ratios were used for continuous and dichotomous variables, respectively."
Reasoning: The summary measures of weighted mean differences and odds ratios are specified.
[Yes]

P14. Methods / Synthesis of results
Quote: "Review Manager (RevMan) software, version 5.3 was used for data statistical analysis" [...] "If the I2 value was < 50%, then a fixed-effects meta-analysis was applied; if the I2 value was ≥ 50%, then a random-effects approach instead of a fixed-effect analysis would be undertaken."
Reasoning: The methods for the meta-analysis are described, including assessing heterogeneity using I2.
[Yes]

P15. Methods / Risk of bias across studies
Reasoning: There is no mention of assessing risk of bias across studies, such as selective reporting within studies or publication bias.
[No]

P16. Methods / Additional analyses
Reasoning: No additional analyses such as subgroup analyses or meta-regression are mentioned.
[No]

P17. Results / Study selection
Quote: "Articles excluded because of failure to meet inclusion criteria (n = 235)"
Reasoning: A flow diagram is provided showing the numbers of studies screened, assessed for eligibility, and included.
[Yes]

P18. Results / Study characteristics
Quote: "Table 1. Study Details of Total Randomized Clinical Trials"
Reasoning: A table is provided showing the key characteristics of each included study.
[Yes]

P19. Results / Risk of bias within studies
Quote: "Table 2. Quality Check of Total Randomized Clinical Trials"
Reasoning: A table is provided showing the results of the quality assessment (risk of bias) for each included study.
[Yes]

P20. Results / Results of individual studies
Reasoning: The results of individual studies are not presented. The forest plots show the pooled results but not the effect estimates and confidence intervals from each study.
[No]

P21. Results / Synthesis of results
Quotes: See Figures 2-6 showing forest plots of the meta-analyses.
Reasoning: The results of the meta-analyses are presented in forest plots with confidence intervals and measures of consistency (heterogeneity).
[Yes]

P22. Results / Risk of bias across studies
Reasoning: There are no results presented assessing the risk of bias across studies, such as publication bias or selective reporting.
[No]

P23. Results / Additional analysis
Reasoning: No additional analyses such as subgroup analyses or meta-regression are reported.
[No]

P24. Discussion / Summary of evidence
Quote: "In this systematic review we summarized total RCTs available in the pediatric surgical literature, focusing on operative time, postoperative complications, and recurrence. Our results show that LH is superior for the inguinal hernia repair in children, with shorter operative time for unilateral hernias in extraperitoneal approaches group as well as for bilateral hernias. Besides, less total postoperative complications was found in the LH group, especially for major postoperative complications in male children."
Reasoning: The main findings are summarized, considering the strength of evidence from RCTs.
[Yes]

P25. Discussion / Limitations
Quote: "However, on one hand, because of the limited number of patients and studies, more RCTs need to be conducted to confirm these findings; on the other hand, the learning curve in the 5 RCTs may play an underestimated role in the study, which may weaken the results of the comparison."
Reasoning: Some limitations are discussed, including the limited number of studies and potential impact of learning curves.
[Yes]

P26. Discussion / Conclusions
Quote: "In this systematic review we summarized total RCTs available in the pediatric surgical literature, focusing on operative time, postoperative complications, and recurrence. Our results show that LH is superior for the inguinal hernia repair in children, with shorter operative time for unilateral hernias in extraperitoneal approaches group as well as for bilateral hernias."
Reasoning: The conclusions provide a general interpretation of the results.
[Yes]

P27. Funding
Reasoning: There is no description of funding sources for the systematic review or the role of any funders.
[No]

92. Friedmacher 2011: Residual aganglionosis after pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis

LLM response

17 quote(s) from publication full text (mean similarity 98.1%)

A1
Quote: "A meta-analysis of redo PT operations for HD reported in the literature between 1985 and 2011 was performed."
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
Quotes: "Detailed information was recorded in patients with RA and transition-zone bowel (TZB), including recurrent bowel problems, histological findings on repeat rectal biopsy, type of redo PT operation and outcome." and "Only publications containing all the relevant details were included in the literature review. Publications not giving adequate clinical data of patients were excluded."
Reasoning: At least two independent data extractors are not mentioned.
[No]

A3
Quotes: "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or transition-zone bowel (TZB) after initial operation between 1985 and 2011." and "The search terms were "residual aganglionosis", "transition-zone bowel", "redo and repeat pull-through", "reoperation Hirschsprung's disease" and "postoperative follow-up and outcome Hirschsprung's disease"."
Reasoning: At least two databases were searched and key terms were provided.
[Yes]

A4
Reasoning: The inclusion of grey literature was not specified.
[No]

A5
Reasoning: A list of included and excluded studies was not provided.
[No]

A6
Quote: "Twenty-nine articles reported 555 patients with HD who underwent redo PT operation. 193 (34.8%) patients demonstrated abnormal histological findings on repeat rectal biopsy, 144 (74.6%) patients revealed RA and 49 (25.4%) patients TZB (Table 1)."
Reasoning: Aggregate data on the characteristics of included studies was provided.
[Yes]

A7
Reasoning: The scientific quality of included studies was not assessed.
[No]

A8
Reasoning: Not applicable as the scientific quality of included studies was not assessed.
[NA]

A9
Reasoning: Not applicable as no quantitative synthesis was performed.
[NA]

A10
Reasoning: The likelihood of publication bias was not assessed.
[No]

A11
Reasoning: Sources of funding and conflicts of interest were not reported.
[No]

P1
Quote: "Residual aganglionosis after pull-through operation for Hirschsprung's disease: a systematic review and meta-analysis"
Reasoning: The title identifies the report as a systematic review and meta-analysis.
[Yes]

P2
Reasoning: A structured abstract with labeled sections is not provided.
[No]

P3
Quote: "Over the years, various PT operations have been used to treat patients with HD [18–23]. It has been shown in several studies that there is no statistically significant difference in the functional outcome with respect to bowel function between the various PT procedures [24–27]."
Reasoning: The rationale for the review is described in the context of what is already known.
[Yes]

P4
Quote: "Purpose Most patients with Hirschsprung's disease (HD) have a satisfactory outcome after pull-through (PT) operation. However, some children continue to have persistent bowel symptoms after the initial operation and may require redo PT. Redo PT operation in HD is usually indicated for anastomotic strictures or residual aganglionosis (RA). We designed this meta-analysis to determine the incidence and outcome of RA among patients with HD following PT operation."
Reasoning: The objectives are stated but do not explicitly reference all PICOS elements.
[No]

P5
Reasoning: The existence of a review protocol is not mentioned.
[No]

P6
Quote: "The search terms were "residual aganglionosis", "transition-zone bowel", "redo and repeat pull-through", "reoperation Hirschsprung's disease" and "postoperative follow-up and outcome Hirschsprung's disease"."
Reasoning: The eligibility criteria in terms of PICOS are partially specified but the rationale is not provided.
[No]

P7
Quote: "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or transition-zone bowel (TZB) after initial operation between 1985 and 2011."
Reasoning: The information sources and dates of coverage are described but the date last searched is not provided.
[No]

P8
Reasoning: The full search strategy is not presented.
[No]

P9
Quote: "Only publications containing all the relevant details were included in the literature review. Publications not giving adequate clinical data of patients were excluded."
Reasoning: The study selection process is partially described.
[No]

P10
Reasoning: The data collection process is not described.
[No]

P11
Reasoning: The data items sought are not explicitly defined.
[No]

P12
Reasoning: The methods for assessing risk of bias in individual studies are not described.
[No]

P13
Reasoning: The principal summary measures are not stated.
[No]

P14
Reasoning: Not applicable as no meta-analysis was performed.
[NA]

P15
Reasoning: Assessment of risk of bias across studies is not mentioned.
[No]

P16
Reasoning: Not applicable as no additional analyses were reported.
[NA]

P17
Quote: "Between 1985 and 2011, 29 published articles reported 555 patients with HD who underwent redo PT operation."
Reasoning: The number of studies included is provided but a flow diagram is not presented and reasons for exclusions at each stage are not given.
[No]

P18
Quote: "Twenty-nine articles reported 555 patients with HD who underwent redo PT operation. 193 (34.8%) patients demonstrated abnormal histological findings on repeat rectal biopsy, 144 (74.6%) patients revealed RA and 49 (25.4%) patients TZB (Table 1)."
Reasoning: Aggregate characteristics of included studies are presented but citations are not provided.
[No]

P19
Reasoning: Risk of bias assessments for individual studies are not reported.
[No]

P20
Reasoning: Results for individual studies are not presented.
[No]

P21
Reasoning: Not applicable as no meta-analysis was performed.
[NA]

P22
Reasoning: Not applicable as assessment of risk of bias across studies was not mentioned.
[NA]

P23
Reasoning: Not applicable as no additional analyses were reported.
[NA]

P24
Quote: "Over the years, various PT operations have been used to treat patients with HD [18–23]. It has been shown in several studies that there is no statistically significant difference in the functional outcome with respect to bowel function between the various PT procedures [24–27]. For a PT operation to be successful, it is essential that all aganglionic bowel is resected and bowel with normal innervations is anastomosed to the anus. Our meta-analysis reveals that RA and TZB are the underlying causes of persistent bowel symptoms in one-third of all patients requiring redo PT operation."
Reasoning: The main findings are summarized.
[Yes]

P25
Quote: "A major problem with the intraoperative frozen section biopsies is that it can indicate the presence of ganglion cells without differentiating between hypo- and dysganglionosis [29]."
Reasoning: Some limitations at the study level are discussed.
[Yes]

P26
Quote: "Constipation after PT operation in the vast majority of patients can be managed by non-operative methods such as laxatives and enemas [10, 11]. Postoperative enterocolitis requires rectal irrigation with or without metronidazole prophylaxis [25]. However, if a patient continues to have persistent constipation, abdominal distension or recurrent episodes of enterocolitis, a full thickness rectal biopsy is indicated to rule out RA or TZB [33]."
Reasoning: A general interpretation is provided in the context of other evidence and implications for future practice are discussed.
[Yes]

P27
Reasoning: Sources of funding for the systematic review are not described.
[No]

93. Friedmacher 2012: Delayed primary anastomosis for management of long-gap esophageal atresia: a meta-analysis of complications and long-term outcome

LLM response

19 quote(s) from publication full text (mean similarity 99.9%)

A1. Was an 'a priori' design provided?
Quotes: None relevant
Reasoning: The article does not mention a protocol, ethics approval, or pre-determined research objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "Data extracted from each participating article included study characteristics (first author, publication year, sample size, follow-up time and mortality rate) and patient characteristics (gestational age, birth weight, type of LGEA and additional congenital anomalies)."
Reasoning: Data extraction was performed, but it is not clear if it was done in duplicate or by two independent people.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A systematic literature search was performed to identify articles reporting cases of LGEA managed by DPA. Common electronic databases as MEDLINE®, EMBASE®, ISI Web of ScienceSM and the Cochrane Library were searched in December 2011 using a combination of the following terms: "esophageal atresia", "long-gap" and "delayed primary anastomosis"."
Reasoning: At least 2 electronic databases were searched along with key terms. However, no supplementary search strategies were mentioned.
[No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant
Reasoning: The article does not state that they searched for reports regardless of publication type or whether they excluded any reports based on publication status.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "In total, data from 44 studies published from 1981 to 2010, were included in the quantitative synthesis."
Reasoning: While the total number of included studies is provided, there is no list of the included and excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: "The overall number of study subjects managed by DPA was 451, ranging from 1 to 74 newborns with LGEA per study. Study and patients characteristics are presented in Table 1."
Reasoning: Aggregate data on the characteristics of included studies is provided in Table 1.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: None relevant
Reasoning: The article does not mention assessing the quality of included studies using any tools or criteria.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
[NA] - Question A7 was answered as No

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "A cumulative meta-analysis revealed the incidences for each specific complication (Table 2). Since not all complications were reported in all articles, each specific complication was recorded as the number of patients in which that complication was present divided by the total number of patients in the cohorts that presented data on that specific complication: anastomotic leaks 62/216 (95 % CI 22.9–35.3), anastomotic strictures 155/272 (95 % CI 50.9–62.9), symptomatic GER 131/274 (95 % CI 41.8–53.9), esophagitis 14/38 (95 % CI 22.3–54.0), dysphagia 12/77 (95 % CI 8.7–26.0), recurrent fistula 12/137 (95 % CI 4.8–15.1), recurrent aspiration pneumonia 6/25 (95 % CI 10.2–45.5), growth retardation 21/108 (95 % CI 12.7–28.4)"
Reasoning: A meta-analysis was appropriately performed to combine the findings. Incidences with 95% confidence intervals were calculated for each complication. Associations between complications were considered significant for p<0.05.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant
Reasoning: The article does not mention assessing publication bias.
[No]

A11. Was the conflict of interest included?
Quotes: "Conflict of interest The authors declare that they have no conflict of interests."
Reasoning: A statement on conflict of interest for the systematic review authors is provided, but not for the included studies.
[No]

P1. Title
Quotes: "Delayed primary anastomosis for management of long-gap esophageal atresia: a meta-analysis of complications and long-term outcome"  
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quotes: The abstract contains labeled sections for Purpose, Methods, Results, and Conclusion.
Reasoning: The abstract is structured with background, methods, results and conclusions.
[Yes]

P3. Introduction / Rationale  
Quotes: "Esophageal atresia (EA) is a relatively common congenital malformation of unknown etiology with an incidence of 1 in 3,500 live births [1]. Pure EA without tracheoesophageal fistula (Fig. 1) is an uncommon variant, comprising 8 % of all patients with EA, with an expected incidence of 1 in 40,000 live births [2]."
Reasoning: The introduction describes the rationale for the review in the context of what is known about esophageal atresia.
[Yes]

P4. Introduction / Objectives
Quotes: "Based on this data, it is recommended to perform a DPA when the patient is 2–4 months old. At this age, the distance between the two ends usually is <2.0 cm [22–24]. Successful primary anastomosis with delays of up to 12 months [25] and initial gaps of up to 7.0 cm [26] or eight vertebral bodies [27] have been reported (Fig. 5)."
Reasoning: The introduction provides an overview of the patient cohorts and interventions examined, but does not explicitly state the PICOS of the review question.
[No]

P5. Methods / Protocol and registration
Quotes: None relevant
Reasoning: The article does not mention a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quotes: "References lists of identified articles were screened for additional studies. There were no language or publication date restrictions. Duplicated articles were deleted."
Reasoning: Some eligibility criteria like no language or publication date restrictions are provided. However, the detailed inclusion/exclusion criteria are not fully specified.
[No]

P7. Methods / Information sources
Quotes: "A systematic literature search was performed to identify articles reporting cases of LGEA managed by DPA. Common electronic databases as MEDLINE®, EMBASE®, ISI Web of ScienceSM and the Cochrane Library were searched in December 2011 using a combination of the following terms: "esophageal atresia", "long-gap" and "delayed primary anastomosis"."
Reasoning: The electronic databases searched are described along with the search date.
[Yes]

P8. Methods / Search
Quotes: "A systematic literature search was performed to identify articles reporting cases of LGEA managed by DPA. Common electronic databases as MEDLINE®, EMBASE®, ISI Web of ScienceSM and the Cochrane Library were searched in December 2011 using a combination of the following terms: "esophageal atresia", "long-gap" and "delayed primary anastomosis"."
Reasoning: The search terms are provided but the full search strategy for reproducibility is not presented.
[No]

P9. Methods / Study selection
Quotes: "Identified articles were reviewed by title, keywords and abstract by one of the authors (F.F.). All articles that did not contain original research data (e.g. letters, editorials, commentaries and reviews) and articles not giving adequate information regarding complication rates and outcome were excluded. Articles in non-English languages were translated by qualified medical translators. An unblinded, standardized full-text assessment of relevant articles was independently performed by both authors (F.F. and P.P.). The data was extracted into an electronic datasheet in a standardized manner."
Reasoning: The process of screening titles/abstracts, assessing full-texts, and including studies in the review is described.
[Yes]

P10. Methods / Data collection process
Quotes: "Data extracted from each participating article included study characteristics (first author, publication year, sample size, follow-up time and mortality rate) and patient characteristics (gestational age, birth weight, type of LGEA and additional congenital anomalies). The primary outcome of this analysis was complication rates."
Reasoning: The data extraction process and variables collected are described, but it is not clear if it was done using a standardized form or in duplicate.
[No]

P11. Methods / Data items
Quotes: "Data extracted from each participating article included study characteristics (first author, publication year, sample size, follow-up time and mortality rate) and patient characteristics (gestational age, birth weight, type of LGEA and additional congenital anomalies). The primary outcome of this analysis was complication rates."
Reasoning: The variables for which data were sought are defined.
[Yes]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant
Reasoning: The article does not mention assessing risk of bias in individual studies.
[No]

P13. Methods / Summary measures
Quotes: "A cumulative meta-analysis revealed the incidences for each specific complication (Table 2). Since not all complications were reported in all articles, each specific complication was recorded as the number of patients in which that complication was present divided by the total number of patients in the cohorts that presented data on that specific complication: anastomotic leaks 62/216 (95 % CI 22.9–35.3), anastomotic strictures 155/272 (95 % CI 50.9–62.9), symptomatic GER 131/274 (95 % CI 41.8–53.9), esophagitis 14/38 (95 % CI 22.3–54.0), dysphagia 12/77 (95 % CI 8.7–26.0), recurrent fistula 12/137 (95 % CI 4.8–15.1), recurrent aspiration pneumonia 6/25 (95 % CI 10.2–45.5), growth retardation 21/108 (95 % CI 12.7–28.4)"
Reasoning: Incidence rates and 95% confidence intervals are reported as the principal summary measures.
[Yes]

P14. Methods / Synthesis of results
[NA] - No meta-analysis was performed

P15. Methods / Risk of bias across studies
[NA] - No meta-analysis was performed

P16. Methods / Additional analyses
[NA] - No meta-analysis was performed

P17. Results / Study selection
Quotes: "In total, data from 44 studies published from 1981 to 2010, were included in the quantitative synthesis." (Figure 2 also shows the study selection flow diagram)
Reasoning: The number of studies screened, assessed for eligibility, and included are reported in the text and in a flow diagram, with reasons for exclusions at each stage.
[Yes]

P18. Results / Study characteristics
Quotes: "The overall number of study subjects managed by DPA was 451, ranging from 1 to 74 newborns with LGEA per study. Study and patients characteristics are presented in Table 1."
Reasoning: Study characteristics for which data were extracted are provided in an aggregate form in Table 1.
[Yes]  

P19. Results / Risk of bias within studies
Quotes: None relevant
Reasoning: The results do not present any data on risk of bias of the included studies.
[No]

P20. Results / Results of individual studies
Quotes: Table 2 presents the number of patients with each complication divided by the total number of patients, for each specific complication.
Reasoning: For the outcomes considered, Table 2 provides the simple summary data for each group, but not the effect estimates and confidence intervals for each study.
[No]

P21. Results / Synthesis of results
[NA] - No meta-analysis was performed

P22. Results / Risk of bias across studies
[NA] - No meta-analysis was performed

P23. Results / Additional analysis
[NA] - No meta-analysis was performed

P24. Discussion / Summary of evidence
Quotes: "With this meta-analysis on complications and long-term outcome in newborns with LGEA managed by DPA, we provide an overview of the available patient cohorts that were published so far. Based on this data, it is recommended to perform a DPA when the patient is 2–4 months old. At this age, the distance between the two ends usually is <2.0 cm [22–24]. Successful primary anastomosis with delays of up to 12 months [25] and initial gaps of up to 7.0 cm [26] or eight vertebral bodies [27] have been reported (Fig. 5)."
Reasoning: The discussion summarizes the main findings and their relevance to key groups like healthcare providers.
[Yes]

P25. Discussion / Limitations
Quotes: "In most studies, early complications after DPA were leaks, which occurred in up to 50 % of their patients [20, 22, 23, 25, 28–40]. Most of the anastomotic leaks were minor and subsided spontaneously on total parenteral nutrition without the need for surgical intervention. However, some investigators reported major disruption and failure of conservative management with need for drainage or reoperation in up to 15 % of their cases [38, 40]."
Reasoning: The discussion addresses some limitations at the study level like the high incidence of leaks and need for reinterventions in some studies. However, review-level limitations like incomplete retrieval of studies or reporting biases are not discussed.
[No]

P26. Discussion / Conclusions
Quotes: "In conclusion, this meta-analysis shows that the DPA provides good long-term functional results. However, the high incidence of GER and associated strictures requires early intervention to prevent ongoing feeding problems due to strictures and esophagitis. Long-term follow-up is recommended because of the potential risk of Barrett's metaplasia."
Reasoning: The conclusions provide a general interpretation of the results in the context of long-term outcomes and implications for clinical practice.
[Yes]

P27. Funding
Quotes: None relevant
Reasoning: The article does not describe sources of funding for the systematic review.
[No]

94. Frongia 2013: Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature

LLM response

23 quote(s) from publication full text (mean similarity 98.8%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: No mention of a protocol, ethics approval, or pre-determined objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quote: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted the data."
Reasoning: Study selection and data extraction were done by a single reviewer, not in duplicate.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A systematic literature search was carried out using the search terms "bowel lengthening", "intestinal lengthening", "longitudinal intestinal lengthening and tailoring", "LILT", "Bianchi procedure", "serial transverse enteroplasty" and "step procedure"."
"The last search was done on December, 10th, 2012. The reference lists of retrieved reports were also cross-screened for additional studies."
Reasoning: At least 2 sources (search terms indicate multiple databases) plus reference screening were used.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quote: "Fig. 2 Screening design and summarized number of screened reports with identified relevant and useable articles during the review process, using the modified flow chart according to the QUOROM statement by Moher et al. [10]."
Reasoning: A flow diagram of included and excluded studies at each stage was provided.
[Yes]

A6. Were the characteristics of the included studies provided?
Quote: "Table 1 List of evaluated and reviewed STEP (n = 109) and LILT (n = 363) procedures in published case reports from 1991 to 2012."
Reasoning: A table listing the characteristics of included studies was provided.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: None relevant.
Reasoning: No assessment of study quality or risk of bias was mentioned.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Reasoning: Since study quality was not assessed, it could not be incorporated into the conclusions.
[NA]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "The statistical analysis was performed using Microsoft Office Excel and SPSS 18.0 for Windows (SPSS Corp., Chicago, IL, USA). All available data were analyzed and the quantitative data have been presented in a descriptive manner as mean and range values, except for length of follow-up where median and range values were indicated. Mean %-values indicated in this review were calculated from all %-values of the respective item published within reviewed reports."
Reasoning: Appropriate descriptive statistics were used to summarize the findings. No meta-analysis was performed.
[NA]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant.
Reasoning: Publication bias was not assessed.
[NA]

A11. Was the conflict of interest included?
Quote: "Conflict of interest: None."
Reasoning: Conflicts of interest for the systematic review were reported, but not for the included studies.
[No]

P1. Title
Quote: "Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
Quote: The abstract contains labeled sections for Purpose, Methods, Results, and Conclusions.
Reasoning: A structured abstract with the required sections is provided.
[Yes]

P3. Introduction / Rationale
Quote: "Short bowel syndrome (SBS) is a serious disorder in which the intestinal resorptive capacity is insufficient to provide an adequate alimentary supply [1]. The estimated incidence in children is 24.5 per 100,000 live births with a higher incidence reported in preterm infants [2]. The estimated mortality is 2/100,000 population/year for children with SBS under 4 years [2] and 37.5% of neonates with SBS [3]. SBS in children occurs after congenital or acquired loss of part of the intestine [4], in most cases due to gastroschisis, necrotizing enterocolitis, mid-gut volvulus and intestinal atresia [5]."
Reasoning: Relevant background information is provided to contextualize the rationale for the review.
[Yes]

P4. Introduction / Objectives
Quote: "The first pivotal aim in the therapy of SBS is to ensure alimentation of the child by parenteral nutrition (PN), which results in significant improvements in mortality rates and improved thrive and quality of life in paediatric SBS [65,66]."
Reasoning: The objective of comparing LILT and STEP for treating SBS in children is implied but not explicitly stated in the introduction.
[No]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a review protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quote: "The articles were included in this review if they met the following criteria: Population: Studies of humans aged 0–18 years. Intervention: Bianchi and STEP procedure, either alone or in combination. Type of study: All study designs were eligible for inclusion. Case series with 1 or more cases were included."
Reasoning: Eligibility criteria for population, intervention, and study design were provided.
[Yes]

P7. Methods / Information sources
Quote: "A systematic literature search was carried out using the search terms "bowel lengthening", "intestinal lengthening", "longitudinal intestinal lengthening and tailoring", "LILT", "Bianchi procedure", "serial transverse enteroplasty" and "step procedure". The last search was done on December, 10th, 2012."
Reasoning: Databases and date of last search were not specified, but search terms were provided.
[No]

P8. Methods / Search
Quotes: None relevant.
Reasoning: The full search strategy was not presented.
[No]

P9. Methods / Study selection
Quote: "Fig. 2 Screening design and summarized number of screened reports with identified relevant and useable articles during the review process, using the modified flow chart according to the QUOROM statement by Moher et al. [10]."
Reasoning: The study selection process was described and illustrated in a flow diagram.
[Yes]

P10. Methods / Data collection process
Quote: "One researcher (GF) who evaluated the articles and extracted the data."
Reasoning: Data extraction was done by a single researcher, but the process was not described in detail.
[No]

P11. Methods / Data items
Quotes: None relevant.
Reasoning: The specific data items collected were not defined.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant.
Reasoning: Assessment of risk of bias in individual studies was not mentioned.
[No]

P13. Methods / Summary measures
Quotes: None relevant.
Reasoning: Summary measures were not explicitly stated.
[No]

P14. Methods / Synthesis of results
Quote: "The statistical analysis was performed using Microsoft Office Excel and SPSS 18.0 for Windows (SPSS Corp., Chicago, IL, USA). All available data were analyzed and the quantitative data have been presented in a descriptive manner as mean and range values, except for length of follow-up where median and range values were indicated. Mean %-values indicated in this review were calculated from all %-values of the respective item published within reviewed reports."
Reasoning: Descriptive statistics were used to summarize the results, but no meta-analysis was performed.
[NA]

P15. Methods / Risk of bias across studies
Quotes: None relevant.
Reasoning: Assessment of risk of bias across studies was not mentioned.
[NA]

P16. Methods / Additional analyses
Quotes: None relevant.
Reasoning: No additional analyses were mentioned.
[NA]

P17. Results / Study selection
Quote: "Fig. 2 Screening design and summarized number of screened reports with identified relevant and useable articles during the review process, using the modified flow chart according to the QUOROM statement by Moher et al. [10]."
Reasoning: A flow diagram presenting the number of studies at each stage of screening was provided.
[Yes]

P18. Results / Study characteristics
Quote: "Table 1 List of evaluated and reviewed STEP (n = 109) and LILT (n = 363) procedures in published case reports from 1991 to 2012."
Reasoning: A table of study characteristics for included studies was provided.
[Yes]

P19. Results / Risk of bias within studies
Quotes: None relevant.
Reasoning: Results of risk of bias assessment for individual studies were not reported.
[No]

P20. Results / Results of individual studies
Quotes: None relevant.
Reasoning: Results for individual studies were not presented, only summary data.
[No]

P21. Results / Synthesis of results
Reasoning: No meta-analysis was performed.
[NA]

P22. Results / Risk of bias across studies
Reasoning: Assessment of risk of bias across studies was not mentioned.
[NA]

P23. Results / Additional analysis
Reasoning: No additional analyses were mentioned.
[NA]

P24. Discussion / Summary of evidence
Quote: "The first pivotal aim in the therapy of SBS is to ensure alimentation of the child by parenteral nutrition (PN), which results in significant improvements in mortality rates and improved thrive and quality of life in paediatric SBS [65,66]. Nevertheless, the long-term application of parenteral nutrition is associated with multiple complications, primarily significant liver dysfunction. While first-line therapy is always conservative, surgery should be taken into account in cases of failed intestinal adaptation. LILT and STEP are both accepted procedures potentially able to wean the child from PN, therefore promoting intestinal autonomy and patient outcome."
Reasoning: The main findings were summarized in the context of the key population (children with SBS).
[Yes]

P25. Discussion / Limitations
Quotes: "multiple reports, calculated mean values in this review are only indicative and only allow a very cautious estimation of effectiveness of both procedures. Therefore, the results are encouraging, but not fully validated and further investigations with larger series are needed."
"A prospective randomized trial including both procedures with emphasis on LILT and STEP, then an insight into indications criteria for LILT and STEP and finally a comparison of associated outcome of both procedures from published data in children."
Reasoning: Some limitations at the review level were acknowledged, such as the inclusion of multiple reports and lack of validation. Study-level limitations were not discussed.
[No]

P26. Discussion / Conclusions
Quote: "LILT and STEP are accepted procedures for non-transplant surgical management of small bowel syndrome in children. Larger series are needed to further assess accurate selection of eligible patients and to estimate effectiveness of procedures. A considerably higher number of cases for accurate evaluation might be accomplished through the widespread use of a centralised register."
Reasoning: The conclusions provided a general interpretation and implications for future research.
[Yes]

P27. Funding
Quote: "Acknowledgements: The authors are very grateful to "Heidelberger Stiftung Chirurgie" for supporting this publication."
Reasoning: Sources of funding for the systematic review were reported.
[Yes]

95. Gallo 2012: Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up

LLM response

18 quote(s) from publication full text (mean similarity 98.6%)

A1. Was an 'a priori' design provided?
Quotes: None relevant
Reasoning: The article does not mention a protocol, ethics approval, or pre-determined research objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "Data about postoperative mortality and morbidity were given in 14 studies with a total of 470 patients (264 LGEA): 344 (73%) patients underwent CI, 99 (21%) children underwent GPU, and 27 (6%) patients underwent JI."
Reasoning: The data extraction process is described, but there is no mention of it being done in duplicate.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings "Esophageal Atresia," "Long-gap," "Esophagoplasty," "Replacement," "Interposition," "Substitution," "Graft," and their combinations. All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliographies of relevant articles was done to identify publications for possible inclusion. Included were prospective, retrospective, and comparative studies."
Reasoning: At least 2 databases were searched along with reference scanning, fulfilling the criteria for a comprehensive search.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant
Reasoning: The inclusion of grey literature or unpublished studies is not mentioned.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "A total of 15 studies (4 comparative retrospective, 8 retrospective, and 3 prospective) including 470 patients (264 LGEA) were identified; 344 (73%) patients underwent CI, 99 (21%) GPU, and 27 (6%) JI."
Reasoning: The number of included studies is provided, but there is no list of the actual studies or excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: See Table 1 which provides details on the author, year, replacement performed, number of patients, and study type for each included study.
Reasoning: An aggregated table provides the key characteristics of the included studies.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: None relevant
Reasoning: The article does not mention assessing the quality of the included studies.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
[NA] - Question A7 was answered "No"

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Studies were divided into the following three groups: JI, CI, and GPU. To perform the statistical overview Comprehensive Meta Analysis software (Version 2.2.064) was used. Data were computed using a random effects approach."
Reasoning: Appropriate meta-analysis methods were used to combine the study findings.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant
Reasoning: Publication bias is not mentioned or assessed in the article.
[No]

A11. Was the conflict of interest included?
Quotes: "Conflict of interest: None"
Reasoning: Conflicts of interest for the systematic review are reported, but not for the individual included studies.
[No]

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quote: "Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up"
Reasoning: The title clearly identifies the article as a meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quote: The abstract contains labeled sections for Aim, Methods, Main Results, and Conclusion.
Reasoning: The abstract is structured with the key required sections.
[Yes]

P3. Introduction / Rationale
Quote: "There is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures."
Reasoning: The rationale for the review is provided in the context of the lack of consensus on the optimal surgical approach.
[Yes]

P4. Introduction / Objectives
Quote: "The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
Reasoning: The objectives are clearly stated, although the PICOS elements are not fully specified.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant
Reasoning: No mention of a protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quote: "The articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up. Main outcome parameters were postoperative survival rate, anastomotic complications (such as leakage and strictures recorded both postoperative and during the follow-up), and graft loss."
Reasoning: The eligibility criteria in terms of outcomes of interest are provided.
[Yes]

P7. Methods / Information sources
Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings "Esophageal Atresia," "Long-gap," "Esophagoplasty," "Replacement," "Interposition," "Substitution," "Graft," and their combinations."
Reasoning: The databases searched and date ranges are specified.
[Yes]

P8. Methods / Search
Quote: The full search strategy is not provided.
Reasoning: Key search terms are mentioned but the full electronic search strategy is not presented.
[No]

P9. Methods / Study selection
Quote: "All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliographies of relevant articles was done to identify publications for possible inclusion. Included were prospective, retrospective, and comparative studies."
Reasoning: The process of screening titles/abstracts and reviewing full-texts is described.
[Yes]

P10. Methods / Data collection process
Quote: None relevant
Reasoning: The data extraction process is not described in detail.
[No]

P11. Methods / Data items
Quote: "The articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up. Main outcome parameters were postoperative survival rate, anastomotic complications (such as leakage and strictures recorded both postoperative and during the follow-up), and graft loss."
Reasoning: The key data items and outcomes of interest are defined.
[Yes]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant
Reasoning: Assessment of risk of bias in individual studies is not mentioned.
[No]

P13. Methods / Summary measures
Quote: "Mortality is similar: postoperative survival rate after CI was 96%, after GPU 90.4%. Anastomotic strictures (16.3% after CI vs 17.7% after GPU) and graft loss (4.2% after CI vs 4.8% after GPU) are comparable after these two procedures."
Reasoning: The primary summary measures are postoperative survival rate, anastomotic strictures, and graft loss.
[Yes]

P14. Methods / Synthesis of results
[NA] - Meta-analysis methods are described but measures of consistency like I2 are not reported.

P15. Methods / Risk of bias across studies
Quotes: None relevant
Reasoning: Methods for assessing risk of bias across studies like publication bias are not mentioned.
[No]

P16. Methods / Additional analyses
Quotes: None relevant
Reasoning: No additional analyses like sensitivity analysis or meta-regression are mentioned.
[No]

P17. Results / Study selection
Quote: "A total of 15 studies (4 comparative retrospective, 8 retrospective, and 3 prospective) including 470 patients (264 LGEA) were identified; 344 (73%) patients underwent CI, 99 (21%) GPU, and 27 (6%) JI."
Reasoning: The number of included studies and patients is provided, but a full study flow diagram is not included.
[No]

P18. Results / Study characteristics
Quote: See Table 1 which provides details on the author, year, replacement performed, number of patients, and study type for each included study.
Reasoning: The characteristics of each included study are presented.
[Yes]

P19. Results / Risk of bias within studies
Quotes: None relevant
Reasoning: Results of the risk of bias assessment of individual studies are not provided, consistent with no risk of bias assessment being mentioned in the methods.
[No]

P20. Results / Results of individual studies
Quotes: Data for individual studies are provided in Tables 2a, 2b, and 2c.
Reasoning: For the main outcomes, data are provided for each study allowing them to be viewed independently.
[Yes]

P21. Results / Synthesis of results
[NA] - No meta-analysis results with confidence intervals or consistency measures are reported.

P22. Results / Risk of bias across studies
[NA] - Risk of bias across studies was not assessed.

P23. Results / Additional analysis
[NA] - No additional analyses were mentioned in the methods.

P24. Discussion / Summary of evidence
Quote: "The present article set out to perform a meta-analysis of the literature regarding esophageal replacement for LGEA or extensive corrosive strictures, in an attempt to elucidate the best approach. Comparison is challenging as outcomes are reported differently. GPU and CI appear comparable regarding the main outcomes of the present study: postoperative mortality, anastomotic complications, and graft loss."
Reasoning: The main findings are summarized, although the strength of evidence for each outcome is not explicitly stated.
[Yes]

P25. Discussion / Limitations
Quote: "Far fewer studies describe the results of GPU and only two authors describe their experience with JI. If all studies about esophageal replacement for LGEA were similar we could compute a simple mean of the effect sizes, but considering the above mentioned methodological heterogeneity a simple comparison of the mean of the event rates described by different investigators seems inadequate."
Reasoning: Some key limitations related to the small number of studies for certain procedures are discussed.
[Yes]

P26. Discussion / Conclusions
Quote: "Concluding, from this systematic review of the most recent experiences in esophageal replacement for LGEA and extensive corrosive strictures, no surgical approach emerges distinctly as the best procedure. Comparison is challenging as outcomes are reported differently. GPU and CI appear comparable regarding the main outcomes of the present study: postoperative mortality, anastomotic complications, and graft loss."
Reasoning: The conclusions provide a general interpretation of the results in the context of the limitations.
[Yes]

P27. Funding
Quotes: None relevant
Reasoning: Sources of funding for the systematic review are not described.
[No]

96. Gosemann 2013: Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome

LLM response

17 quote(s) from publication full text (mean similarity 98.9%)

1 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1
Quote: "We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT."
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
Quotes: "There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other's work."
Reasoning: The methods do not mention duplicate study selection and data extraction or a consensus procedure.
[No]

A3
Quotes: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords "Hirschsprung" and "outcome." Reference lists were screened for additional studies."
Reasoning: At least two electronic databases were not searched, only PubMed was used along with reference screening.
[No]

A4
Reasoning: The inclusion of grey literature was not used as an inclusion criterion and there is no mention of including reports regardless of publication type.
[No]

A5
Quote: "Eighteen articles fulfilled the inclusion criteria and were analyzed in detail."
Reasoning: A list of included studies was not provided and excluded studies were not mentioned.
[No]

A6
Quotes: "A total of 387 patients were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT. The median number of patients in the OPEN group was n = 24 compared with n = 25 in the L-TERPT/TERPT group."
Reasoning: Aggregated data on the number of patients and surgical techniques were provided for the included studies.
[Yes]

A7
Quotes: "Only articles comprehensively describing the surgical methods (OPEN, L-TERPT, TERPT) and reporting on major outcome parameters (soiling/incontinence, constipation, enterocolitis, and/or stricture) were included in this study. Exclusion criteria were follow-up less than 12 months, cohorts smaller than 10 patients, articles in a language other than English, series of total colonic aganglionosis, and publication in nonpeer-reviewed journals."
Reasoning: The scientific quality of included studies was assessed based on specific inclusion/exclusion criteria related to surgical methods, outcome reporting, follow-up duration, and publication type.
[Yes]

A8
Reasoning: The results do not appear to account for the methodological rigor and scientific quality of the included studies when formulating conclusions and recommendations.
[No]

A9
Reasoning: This systematic review did not perform a meta-analysis or assess the appropriateness of combining studies quantitatively.
[NA]

A10
Reasoning: The likelihood of publication bias was not assessed.
[No]

A11
Reasoning: Potential sources of support and conflict of interest are not reported for the systematic review itself or the included studies.
[No]

P1
Quote: "Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2
Quote: See the structured abstract on the first page.
Reasoning: A structured abstract with labeled sections for background, methods, results, and conclusion is provided.
[Yes]

P3
Quote: "Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed. The most relevant long-term complications of HD surgery include constipation, soiling/incontinence, enterocolitis, and anastomotic stricture. To date, there has been no randomized controlled trial evaluating the long-term outcome of OPEN surgery compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT])."
Reasoning: The introduction describes the rationale for the review in the context of existing surgical techniques and lack of comparative long-term outcome data.
[Yes]

P4
Quote: "We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT."
Reasoning: The objective of comparing long-term outcomes between open and transanal pull-through techniques is stated, but without explicit reference to PICOS elements.
[No]

P5
Reasoning: The existence of a review protocol and registration information are not reported.
[No]

P6
Quotes: "Only articles comprehensively describing the surgical methods (OPEN, L-TERPT, TERPT) and reporting on major outcome parameters (soiling/incontinence, constipation, enterocolitis, and/or stricture) were included in this study. Exclusion criteria were follow-up less than 12 months, cohorts smaller than 10 patients, articles in a language other than English, series of total colonic aganglionosis, and publication in nonpeer-reviewed journals."
Reasoning: The eligibility criteria related to PICOS elements and publication characteristics are specified.
[Yes]

P7
Quote: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords "Hirschsprung" and "outcome." Reference lists were screened for additional studies."
Reasoning: The information sources (PubMed and reference lists) and date range are described, but the date last searched is not provided.
[Yes]

P8
Reasoning: The full search strategy is not presented for any of the databases searched.
[No]

P9
Quote: "Eighteen articles fulfilled the inclusion criteria and were analyzed in detail."
Reasoning: The number of included studies is provided but the process of screening and selecting studies is not described in detail.
[No]

P10
Reasoning: The data collection process is not described, such as whether data extraction forms were used, if it was done in duplicate, and if data was obtained from investigators.
[No]

P11
Reasoning: The specific data items sought for extraction are not defined, although the eligibility criteria mention some relevant variables.
[No]

P12
Reasoning: The methods do not describe any assessment of risk of bias in the individual included studies.
[No]

P13
Reasoning: The principal summary measures are not explicitly stated, although rates and percentages are reported for outcomes in the results.
[No]

P14
Reasoning: No meta-analysis was conducted in this systematic review.
[NA]

P15
Reasoning: Methods for assessing risk of bias across studies, such as publication bias or selective reporting, are not specified.
[NA]

P16
Reasoning: No additional analyses beyond the main synthesis are mentioned.
[NA]

P17
Quote: "Eighteen articles fulfilled the inclusion criteria and were analyzed in detail."
Reasoning: The number of included studies is provided but a flow diagram is not presented and the number of studies screened and excluded at each stage is not fully reported.
[No]

P18
Quotes: "A total of 387 patients were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT. The median number of patients in the OPEN group was n = 24 compared with n = 25 in the L-TERPT/TERPT group."
Reasoning: Some key characteristics of the included studies are summarized, such as number of patients and surgical techniques, but a full table of characteristics for each study with citations is not provided.
[No]

P19
Reasoning: Results of risk of bias assessments for the individual studies are not presented.
[No]

P20
Reasoning: Simple summary data for each group and effect estimates with confidence intervals are not provided for each individual study.
[No]

P21
Reasoning: No meta-analysis was performed.
[NA]

P22
Reasoning: No assessment of risk of bias across studies was reported.
[NA]

P23
Reasoning: No additional analyses were reported.
[NA]

P24
Quote: "Functional outcome of surgical techniques for HD is highly variable. The results of the current study confirm a significant advantage of L-TERPT/TERPT over OPEN surgery in terms of soiling/incontinence and constipation. In contrast, no differences were seen for enterocolitis and anastomotic stricture."
Reasoning: The main findings are summarized, including the strength of evidence favoring L-TERPT/TERPT for soiling/incontinence and constipation outcomes.
[Yes]

P25
Quote: "Although the present review of the recent literature revealed a higher incidence of constipation and soiling/incontinence after OPEN surgery compared with L-TERPT/TERPT, these data need to be carefully interpreted. The following limitations of the present analysis and validity of the data on the long-term outcome in the current literature may be discussed:"
Reasoning: Limitations of the review are discussed, such as the need for careful interpretation given limitations of the included studies.
[Yes]

P26
Quote: "Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
Reasoning: The conclusion provides a general interpretation that prospective randomized trials are needed to address weaknesses of the current evidence.
[Yes]

P27
Reasoning: Sources of funding for the systematic review are not reported.
[No]

97. Graziano 2015: Asymptomatic malrotation: Diagnosis and surgical management

LLM response

19 quote(s) from publication full text (mean similarity 98.2%)

1 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. Was an 'a priori' design provided?
Quote: "The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review."
The review questions were established a priori by the APSA committee.
[Yes]

A2. Was there duplicate study selection and data extraction?
Quote: "Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series."
Two separate authors conducted study selection according to PRISMA guidelines.
[Yes]

A3. Was a comprehensive literature search performed?
Quotes: "At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE)."
"A total of 224 abstracts were found in a broad search strategy and screened. No prospective studies were found. Therefore, evaluation of the available literature regarding screening for malrotation included retrospective single institution case series that had no comparison groups. Historical bias, selection bias, and institutional bias were noted in most studies."
Multiple electronic databases were searched. Years and databases used were not specified. Supplemental searching of other sources was not mentioned.
[No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
No list of included or excluded studies was provided.
[No]

A6. Were the characteristics of the included studies provided?
Quote: "Table 4 Ladd procedure for patients with heterotaxy syndrome and asymptomatic malrotation."
A table of included study characteristics was provided.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: "Historical bias, selection bias, and institutional bias were noted in most studies."
Study quality was assessed in terms of risk of bias.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quote: "Multicenter and prospective data should be collected to better assess the risk profile for this complex group of patients. A multidisciplinary approach involving surgery, cardiology, critical care and the patient's caregivers can help guide a watchful waiting management plan in individual cases."
The limitations of the retrospective, single-center studies were considered when formulating the conclusions and recommendations.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
The studies were not combined quantitatively.
[NA]

A10. Was the likelihood of publication bias assessed?
No assessment of publication bias was mentioned.
[NA]

A11. Was the conflict of interest included?
Conflicts of interest for the systematic review authors were not reported. Funding sources of the included studies were not reported.
[No]

P1. Title
Quote: "Asymptomatic malrotation: Diagnosis and surgical management An American Pediatric Surgical Association outcomes and evidence based practice committee systematic review"
The title identifies the article as a systematic review.
[Yes]

P2. Abstract
The abstract is structured with labeled sections for objective, methods, results, and conclusions.
[Yes]

P3. Introduction / Rationale
Quote: "Malrotation, also known as intestinal rotation abnormality (IRA), can pose a great risk to the pediatric patient owing to the potential for a catastrophic event such as midgut volvulus, ischemic bowel, and possible short gut syndrome or death [1]. In the past few decades, imaging modalities for this disorder have improved and become more commonplace. This has resulted in asymptomatic patients being diagnosed with malrotation incidentally during their workups for congenital heart disease or other anomalies [2]."
The rationale for the review is described in the context of what is already known.
[Yes]

P4. Introduction / Objectives
Quote: "The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review."
The review questions are explicitly stated.
[Yes]

P5. Methods / Protocol and registration
No mention of a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quote: "Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection."
Eligibility criteria for study designs, language, and databases are provided with rationale.
[Yes]

P7. Methods / Information sources
Quote: "Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), EMBASE (2000–May 2014), and the Cochrane collection."
Information sources are described with dates of coverage. The search date was not provided.
[No]

P8. Methods / Search
The full search strategies are not presented.
[No]

P9. Methods / Study selection
Quote: "Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series."
The process for selecting studies is described.
[Yes]

P10. Methods / Data collection process
No information is provided on the data extraction process.
[No]

P11. Methods / Data items
No list of data items is provided.
[No]

P12. Methods / Risk of bias in individual studies
Quote: "Historical bias, selection bias, and institutional bias were noted in most studies."
Methods for assessing risk of bias in individual studies are described.
[Yes]

P13. Methods / Summary measures
No summary measures are specified.
[No]

P14. Methods / Synthesis of results
No meta-analysis was performed.
[NA]

P15. Methods / Risk of bias across studies
No methods for assessing risk of bias across studies are specified.
[NA]

P16. Methods / Additional analyses
No additional analyses were reported.
[NA]

P17. Results / Study selection
Quote: "A total of 224 abstracts were found in a broad search strategy and screened. No prospective studies were found. Therefore, evaluation of the available literature regarding screening for malrotation included retrospective single institution case series that had no comparison groups."
The number of studies screened and included are provided. Reasons for exclusions at each stage are not given and no flow diagram is presented.
[No]

P18. Results / Study characteristics
Quote: "Table 4 Ladd procedure for patients with heterotaxy syndrome and asymptomatic malrotation."
Study characteristics are provided in a table with citations.
[Yes]

P19. Results / Risk of bias within studies
Quote: "Historical bias, selection bias, and institutional bias were noted in most studies."
Results of the risk of bias assessments are presented.
[Yes]

P20. Results / Results of individual studies
No results of individual studies are provided, only a summary table.
[No]

P21. Results / Synthesis of results
No meta-analysis was performed.
[NA]

P22. Results / Risk of bias across studies
No assessment of risk of bias across studies was reported.
[NA]

P23. Results / Additional analysis
No additional analyses were reported.
[NA]

P24. Discussion / Summary of evidence
Quotes: "Ryerson et al. conducted a broad search survey of 224 patients with malrotation and an intestinal rotation abnormality (IRA). There were 86 patients who underwent a Ladd procedure prior to hospital discharge. Observation can be considered when extensive education for parents and caregivers and close clinical follow-up."
"Pockett et al. from Alberta reported on 7 asymptomatic patients with HS over three years who underwent elective Ladd procedure. They compared this group to 22 patients without HS, all of whom were symptomatic [11]. Their complication rate in the HS group was 57% (four patients) vs. 9% (2 patients) in the non-HS population."
The main findings are summarized, including their relevance to key groups.
[Yes]

P25. Discussion / Limitations
Quote: "Multicenter and prospective data should be collected to better assess the risk profile for this complex group of patients. A multidisciplinary approach involving surgery, cardiology, critical care and the patient's caregivers can help guide a watchful waiting management plan in individual cases."
Limitations at the study and review level are discussed.
[Yes]

P26. Discussion / Conclusions
Quote: "Our review would support the following management algorithm: When a patient is diagnosed with malrotation as a result of a screening study, particularly on another study, consideration should be given to three factors: 1) presence of symptoms, 2) status of cardiac disease, and 3) age. All patients need to undergo an UGI to confirm the diagnosis. At that point an attempt should be made to further define the anatomy as to whether the patient has true malrotation with a narrow mesenteric stalk, nonrotation with a broad mesentery or patient anatomy with malposition of the duodenum. Patients who are symptomatic should undergo a diagnostic laparoscopy and Ladd procedure but normal anatomy is confirmed. True malrotation may be considered abnormal. Nonrotation and atypical anatomy with duodenal malposition may be more difficult to reliably diagnose since there are some false positives and false negative with any radiologic studies."
A general interpretation of the results is provided in the context of other evidence, with implications for future research.
[Yes]

P27. Funding
No funding sources are reported for the systematic review or the included studies.
[No]

98. Guo 2011: Laparoscopic versus open orchiopexy for non-palpable undescended testes in children: a systemic review and meta-analysis